Association between Male Partner Involvement and the Uptake of Prevention of Mother-to-Child Transmission of HIV (PMTCT) Interventions in Mwanza District, Malawi: A Retrospective Cohort Study

Fatch W Kalembo,Atupele N Mulaga,Du Yukai,Niman I Ahmed,Maggie Zgambo,Patricia Kissinger

doi:10.1371/journal.pone.0066517

Fatch W Kalembo, Atupele N Mulaga + Show 4 more

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https://doi.org/10.1371/journal.pone.0066517

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Abstract

ObjectiveThe main objective of this study was to examine the association between male partner involvement and the uptake of prevention of mother-to-child transmission of HIV (PMTCT) interventions.MethodsA retrospective cohort study was used to collect data on women, their male partners and their children who were enrolled in a PMTCT program from January 2004 to December 2006 at Mwanza District Hospital. HIV infected women and their children were followed-up over the 18 months postnatal period. Data were analyzed using descriptive statistics, chi-square test and logistic regression.ResultsA total of 476 HIV positive women were enrolled in a PMTCT program and were followed-up in the study. Of those followed-up in the study, 65 (13.7%) had a male partner involvement while 411 (86.3%) had no male partner involvement. Male partner involvement was significantly associated with condom use (Adjusted odds ratio [AOR] = 5.6, 95% confidence interval [CI]: 2.3–13.5, P<0.001), hospital delivery (AOR = 25.9, 95%CI: 10.6–63.6, P<0.001), and completion of follow-up in the program (AOR = 16.8, 95% CI: 8.5–33.4, P<0.001).ConclusionMale partner involvement increases the uptake of some PMTCT interventions by HIV positive women. Multi-strategic, culturally tailored public health care models are needed to increase the rate of male partner involvement in the program.

Highlights

Human immunodeficiency virus (HIV) remains a major challenge globally despite decades of advocacy and investment in programs to control the spread of the virus
UNAIDS further estimated that about 2.5 million children globally were living with HIV and 1.8 million of these were from Sub-Saharan Africa [1]
A prevention of mother-to-child transmission of HIV (PMTCT) program consists of a range of interventions, including improved antenatal services, opt-out HIV counseling and testing for pregnant women, antiretroviral drug prophylaxis for HIV positive pregnant women and newborns, referral to support groups, counseling on options for safer infant feeding practices and continued follow-up and treatment for HIV positive mothers and their children for the first 18 months of the child’s life [3,4]

Summary

Introduction

Human immunodeficiency virus (HIV) remains a major challenge globally despite decades of advocacy and investment in programs to control the spread of the virus. UNAIDS estimated that in 2009, 33.3 million people globally were living with HIV. In Malawi 11% of the estimated population of 15 million were living with HIV in 2009. This included 57,000 pregnant women and 120,000 children under the age of 14 [2]. A PMTCT program consists of a range of interventions, including improved antenatal services, opt-out HIV counseling and testing for pregnant women, antiretroviral drug prophylaxis for HIV positive pregnant women and newborns, referral to support groups, counseling on options for safer infant feeding practices and continued follow-up and treatment for HIV positive mothers and their children for the first 18 months of the child’s life [3,4]

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