Abstract
In sub-Saharan Africa (SSA), male partners are rarely present during prevention of mother-to-child transmission (PMTCT) services. This systematic review aims to synthesize, from a male perspective, male partners’ perceived roles, barriers and enablers of their involvement in PMTCT, and highlights persisting gaps. We carried out a systematic search of papers published between 2002 and 2013 in English on Google Scholar and PubMed using the following terms: men, male partners, husbands, couples, involvement, participation, Antenatal Care (ANC), PMTCT, SSA countries, HIV Voluntary Counseling and Testing and disclosure. A total of 28 qualitative and quantitative original studies from 10 SSA countries were included. Men's perceived role was addressed in 28% (8/28) of the studies. Their role to provide money for ANC/PMTCT fees was stated in 62.5% (5/8) of the studies. For other men, the financial responsibilities seemed to be used as an excuse for not participating. Barriers were cited in 85.7% (24/28) of the studies and included socioeconomic factors, gender role, cultural beliefs, male unfriendly ANC/PMTCT services and providers’ abusive attitudes toward men. About 64% (18/28) of the studies reported enablers such as: older age, higher education, being employed, trustful monogamous marriages and providers’ politeness. In conclusion, comprehensive PMTCT policies that are socially and culturally sensitive to both women and men need to be developed.
Highlights
An estimated 1.5 million human immunodeficiency virus (HIV)-positive women become pregnant, and 90% of total HIV infections in children that are acquired through mother-to-child transmission (MTCT) during either pregnancy, labor or breastfeeding occur in sub-Saharan African (SSA) countries (UNAIDS 2013)
The mens role of guaranteeing family income and having to work is often used as an excuse to not accompany their wives to Antenatal Care (ANC)/ Programs to curtail mother-to-child HIV transmission (PMTCT) clinics (Kwambai et al 2013; Larsson et al 2010; Musheke et al 2013)
According to some men’s statements, as part of their responsibility (Aarnio et al 2009; Theuring et al 2009) and in spite of their awareness of women’s financial dependence, they assume that women need their permission to go to ANC/PMTCT sessions because only male partners can decide
Summary
An estimated 1.5 million HIV-positive women become pregnant, and 90% of total HIV infections in children that are acquired through mother-to-child transmission (MTCT) during either pregnancy, labor or breastfeeding occur in sub-Saharan African (SSA) countries (UNAIDS 2013). In the most affected SSA countries, HIV and AIDS-related diseases are still amongst the main causes of disease and death among women and children (UNAIDS 2013). Programs to curtail mother-to-child HIV transmission (PMTCT) have been in place for almost 15 years worldwide. Taking advantage of anti-retroviral drugs availability, countries with a high HIV and AIDS burdens are escalating the provision of PMTCT interventions to respond to demands in underserved areas. There is overwhelming evidence that male partners’ participation in PMTCT is fundamental (Reece, Hollub, Nangami & Lane 2010; Semrau, Kuhn, Vwalika, Kasonde, Sinkala, Kankasa, et al 2005; Theuring, Mbezi, Luvanda, Jordan-Harder, Kunz & Harms 2009), is strongly recommended by World Health Organization and has been contemplated in strategies of many MTCT control programs
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