Abstract
BackgroundPrevention of mother-to-child transmission of HIV (PMTCT) is effective in curbing rates of HIV infection in children because its interventions reduce the rates of transmission during pregnancy, in labour, and in breastfeeding. Male involvement (MI) greatly influences uptake and adherence to PMTCT services. Lack of clarity on the roles and expectations of men in PMTCT is one of the main barriers to MI. The main aim of the study was to explore the roles and expectations of male partners from PMTCT services in Malawi.MethodsThis was a descriptive qualitative study that involved men whose partners were either pregnant or breastfeeding a child, health care workers working in PMTCT services for over six months, and traditional leaders. We conducted 9 in-depth interviews and 12 key informant interviews from January to March 2018. All interviews were audio-recorded, transcribed, and translated. Thematic analysis was employed to analyze data.ResultsThe subjective and community norms and attitudes of men towards PMTCT provide the context in which male partners define the specific roles they render and the services they expect from PMTCT services. The roles of men in PMTCT service were contextualized in what is socially acceptable and normalized in the setting and include supportive roles expressed as accompanying the wife to attend; antenatal care services, Dry blood sample collection (DBS) when its due, keeping appointments when is due to take the ARVs, providing financial support; HIV prevention behavior change and decision-making roles. The desired services within PMTCT include health assessment such as checking their weight; blood pressure; blood sugar and promotion activities such as education sessions that are provided in a male-friendly manner that is in tandem with existing socio-cultural norms and attitudes of men towards such services.ConclusionThe roles of male partners in PMTCT services are underpinned by subjective norms and what is socially acceptable within a specific context. The services that men require from PMTCT services are influenced by their attitudes and beliefs towards PMTCT interventions. Services should be male-tailored provided in an atmosphere that allows and accepts male partners to exercise their roles in PMTCT services.
Highlights
Prevention of mother-to-child transmission of Human Immunodeficiency Virus (HIV) (PMTCT) is effective in curbing rates of HIV infection in children because its interventions reduce the rates of transmission during pregnancy, in labour, and in breastfeeding
None of the men we approached at a health facility refused participation while out of the eight men that we approached in their respective homes five of them refused participation and cited the fear of being followed up by health care workers to investigate their lack of participation in Prevention of mother-to-child transmission of HIV (PMTCT) services
The findings of this study show that subjective and community norms and attitudes of men towards PMTCT provide the context in which male partners define the specific roles they render and the services they expect from PMTCT services
Summary
Prevention of mother-to-child transmission of HIV (PMTCT) is effective in curbing rates of HIV infection in children because its interventions reduce the rates of transmission during pregnancy, in labour, and in breastfeeding. There are documented benefits that MI in PMTCT offers, such as, an increase in adherence and uptake of PMTCT services, HIV testing for both women and men; increase in the number of deliveries done at the hospital; prolonged breastfeeding, and male partner HIV counseling and testing [6,7,8], MI remains low [2, 8, 9] and ranges from 12.5 to 18.7% in Sub-Saharan Africa [10]. Previous studies in Sub-Saharan Africa have demonstrated that despite the efforts to encourage men to be involved in the PMTCT services only a few men respond positively by accompanying their female partners for antenatal services (ANC) and participating in PMTC T programmes [7]
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