Abstract
BackgroundMale partner HIV testing and counseling (HTC) is associated with enhanced uptake of prevention of mother-to-child HIV transmission (PMTCT), yet male HTC during pregnancy remains low. Identifying settings preferred by pregnant women and their male partners may improve male involvement in PMTCT.MethodsParticipants in a randomized clinical trial (NCT01620073) to improve male partner HTC were interviewed to determine whether the preferred male partner HTC setting was the home, antenatal care (ANC) clinic or VCT center. In this nested cross sectional study, responses were evaluated at baseline and after 6 weeks. Differences between the two time points were compared using McNemar’s test and correlates of preference were determined using logistic regression.ResultsAmong 300 pregnant female participants, 54 % preferred home over ANC clinic testing (34.0 %) or VCT center (12.0 %). Among 188 male partners, 68 % preferred home-based HTC to antenatal clinic (19 %) or VCT (13 %). Men who desired more children and women who had less than secondary education or daily income < $2 USD were more likely to prefer home-based over other settings (p < 0.05 for all comparisons). At 6 weeks, the majority of male (81 %) and female (65 %) participants recommended home over alternative HTC venues. Adjusting for whether or not the partner was tested during follow-up did not significantly alter preferences.ConclusionsPregnant women and their male partners preferred home-based compared to clinic or VCT-center based male partner HTC. Home-based HTC during pregnancy appears acceptable and may improve male testing and involvement in PMTCT.
Highlights
Male partner involvement in prevention of mother-tochild HIV transmission (PMTCT) has been associated with enhanced uptake of prevention of mother-to-child HIV transmission (PMTCT) interventions and infant HIV-free survival [1, 2]
In order to determine the most acceptable setting for male partner HIV testing and counseling (HTC), we interviewed participants in a randomized trial on their preferred setting for male partner HTC, either home-based, voluntary counseling and testing (VCT) center-based or antenatal care (ANC) clinic-based HTC
Women were screened during their first antenatal care (ANC) clinic visit and randomized to either a home visit with their male partner or an invitation to bring their male partner to the ANC clinic for couple HTC
Summary
Male partner involvement in prevention of mother-tochild HIV transmission (PMTCT) has been associated with enhanced uptake of PMTCT interventions and infant HIV-free survival [1, 2]. Despite the availability of multiple options, including mobile and fixed voluntary counseling and testing (VCT) centers, antenatal care (ANC) clinic and home-based HTC, less than one-third of male partners of pregnant women undergo individual or couple-based HTC in sub-Saharan Africa [5,6,7,8]. Current options for HTC include VCT center-based testing, antenatal care (ANC) clinicbased testing, or home based testing (HBHCT). Male partner HIV testing and counseling (HTC) is associated with enhanced uptake of prevention of mother-to-child HIV transmission (PMTCT), yet male HTC during pregnancy remains low. Identifying settings preferred by pregnant women and their male partners may improve male involvement in PMTCT
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