610. Barriers and Facilitators to Uptake of Male Partner Attendance for HIV VCT During Prenatal Care in Brazil

Abstract

BackgroundMale partner involvement in sub-Saharan Africa has been investigated and shown to improve outcomes for the entire family. However, little research is available in other regions. In Porto Alegre, Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV voluntary counseling and testing (VCT) to decrease acute HIV serconversion during pregnancy. Uptake of this intervention has been sub-optimal.MethodsFrom November 2016 to July 2017, 202 men who attended prenatal care at Hospital Conceicao and 201 men who did not attend prenatal care were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Multivariate regression was performed to identify factors associated with male involvement in prenatal care.ResultsOf 403 men interviewed, 91% stated they had been invited to prenatal care, 94% of men stated they would accept HIV testing if offered, but only 50% attended. Men identified making their partner happy as the most important facilitator for prenatal care attendance, and having to miss work as the most significant barrier. Frequency of commonly identified barriers and facilities are indicated by Figure 1. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother-to-child transmission (AOR 2.1 95% CI 1.3–3.3), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.8, 95% CI 2.1–50.8). Partnership factors associated with attendance included being invited by partner (AOR 5.6, 95% CI 2.4–15.6), whereas admitting jealous behavior was negatively associated with attendance (AOR 0.82 95% CI 0.7–0.97). Systemic factors negatively associated with prenatal care attendance included a history of not affording medical care (AOR 0.28, 95% CI 0.15–0.55) and identifying work as a barrier (AOR 0.19 95% CI 0.11–0.31).ConclusionInvolvement of male partners during pregnancy may be enhanced by providing free care during flexible hours. Partners should be actively invited to prenatal care as once involved, almost all would accept HIV VCT and other interventions to protect partners and infants from HIV and other sexually transmitted diseases during this vulnerable period. Disclosures All authors: No reported disclosures.