1
|
Moseley P, Bamford A, Eisen S, Lyall H, Kingston M, Thorne C, Piñera C, Rabie H, Prendergast AJ, Kadambari S. Resurgence of congenital syphilis: new strategies against an old foe. THE LANCET. INFECTIOUS DISEASES 2024; 24:e24-e35. [PMID: 37604180 DOI: 10.1016/s1473-3099(23)00314-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 08/23/2023]
Abstract
Congenital syphilis is a major global cause of fetal loss, stillbirth, neonatal death, and congenital infection. In 2020, the global rate of congenital syphilis was 425 cases per 100 000 livebirths-substantially higher than WHO's elimination target of 50 cases per 100 000 livebirths. Case rates are rising in many high-income countries, but remain low compared with those in low-income and middle-income settings. This Review aims to summarise the current epidemiology and knowledge on transmission and treatment of syphilis in pregnancy, and proposes measures to reduce the rising incidence seen worldwide. We also describe emerging diagnostic and treatment tools to prevent vertical transmission and improve management of congenital syphilis. Finally, we outline a programme of public health priorities, which include research, clinical, and preventive strategies.
Collapse
Affiliation(s)
- Philip Moseley
- University of Queensland Frazer Institute, University of Queensland, Brisbane, QLD, Australia
| | - Alasdair Bamford
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; University College London Great Ormond Street Institute of Child Health, London, UK
| | - Sarah Eisen
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - Claire Thorne
- University College London Great Ormond Street Institute of Child Health, London, UK
| | | | - Helena Rabie
- Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa; Tygerberg Academic Hospital, Cape Town, South Africa
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Blizard Institute, Queen Mary University of London, London, UK
| | - Seilesh Kadambari
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; University College London Great Ormond Street Institute of Child Health, London, UK.
| |
Collapse
|
2
|
Roudsari RL, Sharifi F, Goudarzi F. Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis. BMC Public Health 2023; 23:818. [PMID: 37143008 PMCID: PMC10158256 DOI: 10.1186/s12889-023-15692-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Despite emphasizing the importance and benefits of men's active engagement in reproductive health programs, their engagement in reproductive health care is low. Researchers have identified different barriers to men's avoidance of participation in various aspects of reproductive health in different parts of the world. This study provided an in-depth review of the hindrances to men's non-participation in reproductive health. METHODS This meta-synthesis was conducted using keyword searches in databases including PubMed, Scopus, Web of Science, Cochrane, and ProQuest until January 2023. Qualitative English-language studies that investigated barriers to men's participation in reproductive health were included in the study. The critical appraisal skills program (CASP) checklist was used to assess the articles' quality. Data synthesis and thematic analysis were done using the standard method. RESULT This synthesis led to the emergence of four main themes such as failure to access all inclusive and integrated quality services, economic issues, couples' personal preferences and attitudes, and sociocultural considerations to seek reproductive healthcare services. CONCLUSION Healthcare system programs and policies, economic and sociocultural issues, and men's attitudes, knowledge, and preferences, influence men's participation in reproductive healthcare. Reproductive health initiatives should focus on eliminating challenges to men's supportive activities to increase practical men's involvement in reproductive healthcare.
Collapse
Affiliation(s)
- Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farangis Sharifi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Goudarzi
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
- Department of Midwifery, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
| |
Collapse
|
3
|
Yeganeh N, Kreitchmann R, Leng M, Nielsen-Saines K, Gorbach PM, Klausner JD. Diagnosis and treatment of sexually transmitted infections in male partners of pregnant women in Brazil. Int J STD AIDS 2021; 32:1242-1249. [PMID: 34311604 PMCID: PMC8608751 DOI: 10.1177/09564624211032759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sexually transmitted infections (STIs) can adversely affect a woman's pregnancy and the health of the developing fetus. The source of these infections may be the male sexual partner who remains under-diagnosed and un-treated due to a combination of lack of symptoms, decreased access to health care, and poor health-seeking behaviors. From September 2018 to November 2019, we offered a cohort of pregnant women (gestational age range: 4.6-41 weeks) clinic-based STI testing for HIV and syphilis (via lateral flow assay rapid tests) and for Neisseria (N.) gonorrhoeae, Chlamydia (C.) trachomatis, and Trichomonas (T.) vaginalis (via PCR-based testing) at Santa Casa Hospital and 10 affiliated prenatal clinics in Porto Alegre, Brazil. 400 women between the ages of 18 and 46 years (mean age: 27 years) enrolled and 24% were diagnosed with an STI. Each woman enrolled agreed to invite their male partners to clinic for the same panel of STI testing, and 255 men (64%) between the ages of 18 and 64 years (mean age: 29 years) attended clinic and all accepted full intervention. In these male partners, 40 (16%) were diagnosed with an STI including 22 (8.7%) testing positive for C. trachomatis, 15 (6%) for treponemal antibody (syphilis), 7 (2.8%) for T. vaginalis, 3 (1.2%) for N. gonorrhoeae, and 1 (0.4%) for HIV antibody. In our multivariate analysis, having symptoms of an STI (AOR 4.5, 95% CI 1.3-15.2) and arguing about jealousy (AOR 3.1, 95% CI 1.2-8.2) remained significantly associated with male diagnosis of an STI. Sexually transmitted infections are common in sexual partners of pregnant women in Brazil and should be addressed to prevent reinfection of pregnant women.
Collapse
Affiliation(s)
- Nava Yeganeh
- Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Regis Kreitchmann
- Irmandade da Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil and Federal University Of Health Sciences, Porto Alegre, Brazil
| | - Mei Leng
- Department of Medicine Biostats, UCLA, Los Angeles CA, USA
| | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Jeffrey D Klausner
- Department of Internal Medicine, Division of Infectious Disease, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| |
Collapse
|
4
|
Matthews LT, Psaros C, Mathenjwa M, Mosery N, Greener LR, Khidir H, Hovey JR, Pratt MC, Harrison A, Bennett K, Bangsberg DR, Smit JA, Safren SA. Demonstration and acceptability of a safer conception intervention for men with HIV in South Africa (Preprint). JMIR Form Res 2021; 6:e34262. [PMID: 35507406 PMCID: PMC9118009 DOI: 10.2196/34262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/24/2022] [Accepted: 03/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Many men with HIV (MWH) want to have children. HIV viral suppression minimizes sexual HIV transmission risks while allowing for conception and optimization of the health of men, their partners, and their infants. Objective This study developed and evaluated the feasibility and acceptability of an intervention to promote serostatus disclosure, antiretroviral therapy (ART) uptake and adherence, and viral suppression among MWH who want to have children in South Africa. Methods We developed a safer conception intervention (Sinikithemba Kwabesilisa or We give hope to men) to promote viral suppression via ART uptake and adherence, HIV serostatus disclosure, and other safer conception strategies for MWH in South Africa. Through 3 counseling and 2 booster sessions over 12 weeks, we offered education on safer conception strategies and aided participants in developing a safer conception plan. We recruited MWH (HIV diagnosis known for >1 month), not yet accessing ART or accessing ART for <3 months, in a stable partnership with an HIV-negative or unknown-serostatus woman, and wanting to have a child in the following year. We conducted an open pilot study to evaluate acceptability based on patient participation and exit interviews and feasibility based on recruitment and retention. In-depth exit interviews were conducted with men to explore intervention acceptability. Questionnaires collected at baseline and exit assessed disclosure outcomes; CD4 and HIV-RNA data were used to evaluate preliminary impacts on clinical outcomes of interest. Results Among 31 eligible men, 16 (52%) enrolled in the study with a median age of 29 (range 27-44) years and a median time-since-diagnosis of 7 months (range 1 month to 9 years). All identified as Black South African, with 56% (9/16) reporting secondary school completion and 44% (7/16) reporting full-time employment. Approximately 44% (7/16) of participants reported an HIV-negative (vs unknown-serostatus) partner. Approximately 88% (14/16) of men completed the 3 primary counseling sessions. In 11 exit interviews, men reported personal satisfaction with session content and structure while also suggesting that they would refer their peers to the program. They also described the perceived effectiveness of the intervention and self-efficacy to benefit. Although significance testing was not conducted, 81% (13/16) of men were taking ART at the exit, and 100% (13/13) of those on ART were virally suppressed at 12 weeks. Of the 16 men, 12 (75%) reported disclosure to pregnancy partners. Conclusions These preliminary data suggest that safer conception care is acceptable to men and has the potential to reduce HIV incidence among women and their children while supporting men’s health. Approximately half of the men who met the screening eligibility criteria were enrolled. Accordingly, refinement to optimize uptake is needed. Providing safer conception care and peer support at the community level may help reach men. Trial Registration ClinicalTrials.gov NCT03818984; https://clinicaltrials.gov/ct2/show/NCT03818984 International Registered Report Identifier (IRRID) RR2-https://doi.org/10.1007/s10461-017-1719-4
Collapse
Affiliation(s)
- Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mxolisi Mathenjwa
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
| | - Nzwakie Mosery
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
| | - Letitia Rambally Greener
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
- Population Services International, Johannesburg, South Africa
| | - Hazar Khidir
- Harvard Combined Residency Program in Emergency Medicine, Boston, MA, United States
| | - Jacquelyn R Hovey
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Madeline C Pratt
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Abigail Harrison
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, United States
| | - Kara Bennett
- Bennett Statistical Consulting, Ballston Lake, NY, United States
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University - Portland State University, Portland, OR, United States
| | - Jennifer A Smit
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
| | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, United States
| |
Collapse
|
5
|
Ngangue P, Fleurantin M, Adekpedjou R, Philibert L, Gagnon MP. Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study. Am J Mens Health 2021; 15:15579883211006003. [PMID: 33874810 PMCID: PMC8060766 DOI: 10.1177/15579883211006003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This mixed-methods study aimed to determine the level of male involvement in the
prevention of mother-to-child transmission (PMTCT) services in Haiti and
identify barriers and associated factors. From May to June 2018, a questionnaire
was used to measure the level of male involvement. Semistructured interviews
with pregnant women were also conducted. Multivariate linear regression and
qualitative content analyses were performed to explore factors associated and
barriers to male partners’ involvement in PMTCT services. One hundred and two
pregnant women living with HIV completed the questionnaire. About 47% of male
partners had a high level of involvement. Specifically, 90% financially
supported their spouse, and 82% knew her appointment date at the antenatal
clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and
19% routinely used a condom during sexual intercourse. Factors associated with
male involvement in PMTCT were being married and sharing HIV status with the
male partner. Male partners with a positive HIV status were more likely to be
involved in PMTCT. Qualitative findings revealed that barriers to male
involvement included the conflict between opening hours of the ANC and the male
partner’s schedule, waiting time at the ANC, and the perception of antenatal
care as being women’s business. Overall male partners’ involvement in PMTCT
services is moderate. Gender relations, sociocultural beliefs, and care
organization are likely to hinder this involvement. Developing and implementing
contextually and culturally accepted strategies for male partners of pregnant
women could contribute to strengthening their involvement in the PMTCT
program.
Collapse
Affiliation(s)
- Patrice Ngangue
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | - Leonel Philibert
- Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada
| | | |
Collapse
|
6
|
Galle A, Plaieser G, Van Steenstraeten T, Griffin S, Osman NB, Roelens K, Degomme O. Systematic review of the concept 'male involvement in maternal health' by natural language processing and descriptive analysis. BMJ Glob Health 2021; 6:e004909. [PMID: 33846143 PMCID: PMC8048011 DOI: 10.1136/bmjgh-2020-004909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Experts agree that male involvement in maternal health is a multifaceted concept, but a robust assessment is lacking, hampering interpretation of the literature. This systematic review aims to examine the conceptualisation of male involvement in maternal health globally and review commonly used indicators. METHODS PubMed, Embase, Scopus, Web of Science and CINAHL databases were searched for quantitative literature (between the years 2000 and 2020) containing indicators representing male involvement in maternal health, which was defined as the involvement, participation, engagement or support of men in all activities related to maternal health. RESULTS After full-text review, 282 studies were included in the review. Most studies were conducted in Africa (43%), followed by North America (23%), Asia (15%) and Europe (12%). Descriptive and text mining analysis showed male involvement has been conceptualised by focusing on two main aspects: psychosocial support and instrumental support for maternal health care utilisation. Differences in measurement and topics were noted according to continent with Africa focusing on HIV prevention, North America and Europe on psychosocial health and stress, and Asia on nutrition. One-third of studies used one single indicator and no common pattern of indicators could be identified. Antenatal care attendance was the most used indicator (40%), followed by financial support (17%), presence during childbirth (17%) and HIV testing (14%). Majority of studies did not collect data from men directly. DISCUSSION Researchers often focus on a single aspect of male involvement, resulting in a narrow set of indicators. Aspects such as communication, shared decision making and the subjective feeling of support have received little attention. We believe a broader holistic scope can broaden the potential of male involvement programmes and stimulate a gender-transformative approach. Further research is recommended to develop a robust and comprehensive set of indicators for assessing male involvement in maternal health.
Collapse
Affiliation(s)
- Anna Galle
- ICRH, Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Gaëlle Plaieser
- ICRH, Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | | | - Sally Griffin
- International Centre for Reproductive Health - Mozambique (ICRHM), Maputo, Mozambique
| | - Nafissa Bique Osman
- Departamento de Obstetrícia e Ginecologia, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Kristien Roelens
- Department of Human Structure and Repair, Ghent University, Gent, Belgium
| | - Olivier Degomme
- ICRH, Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| |
Collapse
|
7
|
Determinants of Male Partner Involvement during Antenatal Care among Pregnant Women in Gedeo Zone, South Ethiopia: A Case-Control Study. Ann Glob Health 2021; 87:19. [PMID: 33633930 PMCID: PMC7894374 DOI: 10.5334/aogh.3003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Male involvement during antenatal care is an influential strategy for improving maternal health service utilization, especially institutional delivery. In Ethiopia, only one-fifth of pregnant women were accompanied to antenatal care. It is among those neglected issues, as it is not well studied, specifically determinant factors of male involvement during antenatal care are not known. Objective: This study aimed to identify the determinants of male partner involvement during antenatal care among pregnant women in Gedeo Zone, South Ethiopia. Methods: Community based unmatched case-control study was carried out from January to March 2019 among 804 (cases-402 and controls-402) selected pregnant women having antenatal follow up in Gedeo zone by stratified sampling technique. Data was collected using a pretested, structured, interviewer-administered questionnaire. A survey was conducted in the 22 selected kebeles in the Gedeo zone to identify cases and control. The data was entered using Epi-data and exported to SPSS (Statistical Package for Social Sciences) for analysis. Descriptive analysis like frequency, percentage, rates, and inferential analysis such as binary logistic regression are used. Statistical significance is declared at α < 0.05. The result is presented using text and tables. Results: Husband and maternal age difference (AOR = 1.12, 95% CI [1.06, 1.18]), maternal age at marriage (AOR = 0.86, 95% CI[0.81,0.93]), women empowerment (AOR = 0.20, 95% CI[0.13, 0.30]), type of nearby health facility (AOR = 4.94, 95% CI[1.67, 14.60]) and provider invitation of male partner to antenatal care examination room (AOR = 0.32, 95% CI[0.20, 0.51]) were determinants of male partner involvement during antenatal care. Conclusions: Age difference between husband and wife, age at marriage, women empowerment, type of nearby health facility and male invitation by health providers to antenatal care examination room determines male partner antenatal care involvement. Promoting women empowerment and inviting a male partner to antenatal care are recommended to encourage male involvement during antenatal care.
Collapse
|
8
|
Baker Z, Gorbach P, de Melo MG, Varela I, Sprinz E, Santos B, de Melo Rocha T, Simon M, Almeida M, Lira R, Chaves MC, Kerin T, Nielsen-Saines K. The Effect of Partnership Presence and Support on HIV Viral Suppression Among Serodiscordant Partnered and Single Heterosexual HIV-Positive Individuals in Brazil. AIDS Behav 2021; 25:1946-1953. [PMID: 33389326 PMCID: PMC7778561 DOI: 10.1007/s10461-020-03124-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 01/31/2023]
Abstract
HIV-negative individuals in serodiscordant partnerships experience reduced risk of HIV acquisition when their partners adhere to ART and achieve undetectable viral loads. Partnership support may encourage ART adherence, reducing viral load and the risk of HIV transmission. This study aims to determine whether HIV viral suppression is associated with partnership status and partnership support among 201 HIV positive (HIV+ individuals in serodiscordant partnerships and 100 HIV+ unpartnered individuals receiving care at Hospital Nossa Senhora da Conceição in Porto Alegre, Brazil between 2014 and 2016. Clinical data and patient-reported questionnaire data were assessed, and propensity scores were used to control for confounding variables in adjusted logistic regression models. Viral suppression did not significantly differ between HIV+ partnered (78.5% virally suppressed) and unpartnered (76.0% virally suppressed) individuals. Among individuals in partnerships, viral suppression was significantly associated with having a partner who attended monthly clinic visits (AOR 2.99; 95% CI 1.00-8.93). Instrumental social support-attending monthly visits-may improve the odds of viral suppression among HIV+ individuals in serodiscordant relationships.
Collapse
Affiliation(s)
- Zoë Baker
- grid.239546.f0000 0001 2153 6013Division of Urology, Children’s Hospital Los Angeles, 4650 W. Sunset Blvd, MS #114, Los Angeles, CA 90027 USA
| | - Pamina Gorbach
- grid.19006.3e0000 0000 9632 6718Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA USA
| | | | - Ivana Varela
- grid.414914.dHospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | - Eduardo Sprinz
- grid.414914.dHospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | - Breno Santos
- grid.414914.dHospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | | | - Mariana Simon
- grid.414914.dHospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | - Marcelo Almeida
- grid.414914.dHospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | - Rita Lira
- grid.414914.dHospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | | | - Tara Kerin
- grid.19006.3e0000 0000 9632 6718Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA USA
| | - Karin Nielsen-Saines
- grid.19006.3e0000 0000 9632 6718Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA USA
| |
Collapse
|
9
|
Clark J, Sweet L, Nyoni S, Ward PR. Improving male involvement in antenatal care in low and middle-income countries to prevent mother to child transmission of HIV: A realist review. PLoS One 2020; 15:e0240087. [PMID: 33057353 PMCID: PMC7561142 DOI: 10.1371/journal.pone.0240087] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/21/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Childhood Human Immunodeficiency Virus (HIV) infection occurs almost exclusively via mother to child transmission (MTCT) during pregnancy, birth, or through breastfeeding. Recent studies have shown that male involvement (MI) in antenatal care (ANC) and HIV testing, including couples voluntary counselling and testing (CVCT), increases the likelihood that women will adhere to prevention advice and comply with HIV treatment if required during their pregnancy; hence reducing the rates of MTCT of HIV. This realist review investigates how, why, when, and for whom MI in ANC works best to provide contextual advice on how MI in ANC can be best used for prevention of mother to child transmission (PMTCT) of HIV. METHODS A realist review of existing evidence was conducted. Realist review seeks to explain how and why an intervention works, or does not work, in a given context. This was completed through the five stages of realist synthesis; Eliciting the program theory, search strategy, study selection criteria, data extraction, and data analysis and synthesis. Findings are presented as context-mechanism-outcome (CMO) configurations outlining the mechanisms that work in given contexts to give an outcome. RESULTS Three CMO configurations were developed. These describe that 1) Couples in monogamous relationships have higher levels of trust, commitment and security leading to increased uptake of PMTCT programs together; 2) ANC spaces that make 'male friendly' adaptions promote normalisation of MI in PMTCT and are more welcoming, leading to increased willingness of male partners to participate in ANC; and 3) couples and communities with higher health literacy encourage increased informed decision making, ownership, and responsibility and thus increased participation in PMTCT of HIV. CONCLUSIONS The CMOs developed in this review give contextual advice on how one might improve ANC services to increase MI and help reduce MTCT of HIV. We propose that MI in ANC works best where couples are monogamous and trusting, where ANC spaces actively promote being a 'male friendly space' and where there are high levels of community education programs around MTCT.
Collapse
Affiliation(s)
- Jacinta Clark
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University and Western Health Partnership, Burwood, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Simangaliso Nyoni
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Paul R. Ward
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| |
Collapse
|
10
|
Irfan A, Kazmi SK, Anwar Z, Khan FMA, Khan J, Arif Y, Noor M, Shakil A, Hassan W, Ali R, Tariq S, Tariq N, Mahmood S, Fatima K. Knowledge and attitude of pregnant women regarding HIV transmission, prevention and associated factors in Karachi, Pakistan - A cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 21:46-50. [PMID: 31395233 DOI: 10.1016/j.srhc.2019.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/27/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study aimed to assess the misconceptions and attitude regarding HIV transmission and prevention among antenatal mothers, with regards to mother-to-child-transmission (MTCT) in three tertiary care hospitals of Karachi. METHODS A cross-sectional study comprising 350 pregnant females was conducted at three tertiary care hospitals in Karachi for 4 months, in 2018. A structured questionnaire covering knowledge about MTCT, prevention of mother-to-child-transmission (PMTCT) and attitudes about HIV transmission was used and all collected data entered and analyzed via SPSS (Statistical Package for the Social Sciences) software version 25, owned by the IBM Company. PRINCIPLE RESULTS Of the 350 pregnant females participating, around 66.7% (N = 232) were urban residents, lying in their mid-twenties and over 86% (N = 303) were Muslims. Over 14.3% (N = 52) of the participants had full knowledge regarding MTCT of HIV, with only 6% of the respondents having full knowledge related to PMTCT of HIV. Significant associations were found between knowledge about MTCT and residence (p = 0.001), education level (p = 0.001) and expected response from the partner (p = 0.001). While only 17% (60 out of 350) women agreed to invite their partner for testing, 84% showed an interest in looking after an HIV infected family member and 49% believed that all pregnant females should be tested for HIV. CONCLUSIONS This study shows that majority of the pregnant women in Karachi are unaware of MTCT and PMTCT and they are reluctant towards routine HIV testing. Thus, we see the need for collective and focused efforts for educational programs and further research.
Collapse
Affiliation(s)
- Abeerah Irfan
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Zoha Anwar
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Javeria Khan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Yumna Arif
- Dow University of Health Sciences, Karachi, Pakistan
| | - Maria Noor
- Dow University of Health Sciences, Karachi, Pakistan
| | - Ayesha Shakil
- Dow University of Health Sciences, Karachi, Pakistan
| | - Wardah Hassan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Rimmel Ali
- Dow University of Health Sciences, Karachi, Pakistan
| | - Salman Tariq
- Dow University of Health Sciences, Karachi, Pakistan
| | - Naveen Tariq
- Dow University of Health Sciences, Karachi, Pakistan
| | - Samar Mahmood
- Dow University of Health Sciences, Karachi, Pakistan
| | - Kaneez Fatima
- Dow University of Health Sciences, Karachi, Pakistan
| |
Collapse
|
11
|
Yeganeh N, Kerin T, Simon M, Nielsen-Saines K, Klausner JD, Santos B, Melo M, Fitter S, Gorbach PM. Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil. Int J STD AIDS 2019; 30:875-884. [PMID: 31159712 DOI: 10.1177/0956462419845225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Male partner involvement in prenatal care has been shown to improve outcomes for the entire family in low- and middle income countries. In Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV testing. From November 2016 to July 2017, male partners of women delivering at Hospital Conceiçao were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Of 403 men interviewed, 202 attended prenatal care and 201 did not. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother to child transmission (AOR 2.13, 95% CI: 1.35–3.4), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.24, 95% CI: 1.9–47.5). Partnership factors associated with attendance included invitation by partner (AOR 5.6, 95% CI: 2.4–15.6). Systemic factors negatively associated with prenatal care attendance included a history of not being able to afford medical care (AOR 0.3, 95% CI: 0.15–0.6) and identifying work as a barrier to prenatal care attendance (AOR 0.19 95% CI: 0.11–0.31). Partners should be actively invited to prenatal care during flexible flexible hours. Once involved, almost all would accept HIV and sexually transmitted infection (STI) testing to protect partners and unborn infants during this vulnerable period.
Collapse
Affiliation(s)
- Nava Yeganeh
- 1 Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Tara Kerin
- 1 Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Karin Nielsen-Saines
- 1 Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jeffrey D Klausner
- 3 Department of Internal Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Breno Santos
- 2 Grupo Hospitalar Conceição, Porto Alegre, Brazil
| | | | - Samantha Fitter
- 1 Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Pamina M Gorbach
- 4 Department of Epidemiology, Fielding School of Public Health at UCLA, Los Angeles, CA, USA
| |
Collapse
|
12
|
Strategies for engaging men in HIV services. Lancet HIV 2019; 6:e191-e200. [PMID: 30777726 DOI: 10.1016/s2352-3018(19)30032-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 12/14/2022]
Abstract
The importance of men in the global HIV response is increasingly recognised. In most settings, men are less engaged in HIV services and have worse health outcomes than women. The multiple gender, social, economic, political, and institutional factors behind these patterns are well documented. More recently, researchers have been reporting evidence on strategies aimed at improving the engagement of men in HIV services. Several promising approaches exist, including community-based outreach programmes, gender-transformative interventions to shift gender norms and practices, and the development of more responsive, male-friendly health services. Challenges remain, however, in terms of cost and sustainability, intersecting inequalities like race and class, and the difficulty of changing community-level gender norms. Future research should focus on developing theory-informed interventions and evaluations, on improving the understanding of specific subpopulations of men, and on broadening the evidence base beyond the few countries that produce most research in this field.
Collapse
|