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Male partner involvement may help eliminate MTCT of HIV
Male partners are critical to the prevention of mother-to-child HIV transmission in low-resource, high-disease burden areas, according to researchers at the University of Kenya and the University of Washington.
In addition, the evidence shows that male partner involvement is a boon to non-HIV related outcomes, such as promoting skilled deliveries, exclusive breast-feeding, effective family planning and infant immunizations.
“Involving men in all components of PMTCT (preventing mother-to-child transmission) has potential to contribute substantially to achieving virtual elimination of mother-to-child HIV transmission; promoting partner-friendly programs and policies, as well as pursuing research into numerous gaps in knowledge identified in this review, will help drive this process,” the authors wrote in their review.
Despite these positive associations, few men in the regions most affected by the HIV epidemic are involved in PMTCT activities and reproductive health. For instance, studies across sub-Saharan Africa found that the rates of male partner HIV testing and counseling ranged from 5% to 33%; most studies reported that less than one in five men get HIV tested during their partner’s pregnancy. A retrospective study from Uganda showed that less than 5% of male partners underwent HIV testing and counseling.
Various studies showed that male partner support improves uptake and adherence to antiretroviral therapy, according to the researchers. In one study, women in Kenya were three times as likely to take a single dose of nevirapine at delivery when their male partners accompanied them to antenatal clinics and participated in couple HIV counseling and testing. In Malawi, male partner support was associated with improved uptake of PMTCT interventions and better HIV-free survival in children.
The research shows that several strategies have been used to increase male involvement in PMTCT. The most successful was home-based couple testing and education during pregnancy. A randomized trial included 300 pregnant women in Kenya demonstrated that visiting pregnant women and their partners at home yielded a 85% testing rate for the male partners vs. 36% of male partners in the clinic based arm.
“Determining cost-effective ways to implement home-based couple HIV testing and counseling will be critical for this to be successful,” the authors wrote.
“In low-resource settings with high mother-to-child HIV transmission rates, male partners must be considered part of the this approach because they often make key decisions that affect the health of women and their children, including the use of PMTCT interventions, family planning and access to medical care,” the researchers concluded.
Disclosure: The authors report no relevant financial disclosures.