Abstract

BackgroundMale partner involvement in antenatal voluntary HIV counseling and testing (VCT) has been shown to increase uptake of interventions to reduce the risk of HIV transmission in resource-limited settings. We aimed to identify methods for increasing male involvement in antenatal VCT and determine male correlates of accepting couple counseling in these settings.Methodology/Principal FindingsWe invited women presenting to a Nairobi antenatal clinic to return with their male partners for individual or couples VCT. Male attitudes towards VCT and correlates of accompanying female partners to antenatal clinic and receiving couple counseling were determined. Of 1,993 women who invited their partner, 313 (16%) returned with their partners to ANC. Men attending antenatal clinic were married (>99%), employed (98%), and unlikely to report prior HIV testing (14%). Wanting an HIV test (87%) or health information (11%) were the most commonly cited reasons for attending. Most (95%) men who came to antenatal clinic accepted HIV testing and 39% elected to receive counseling as a couple. Men who received counseling with partners were younger, had fewer children, and were less knowledgeable about prevention of mother-to-child HIV transmission (PMTCT) than those who received counseling individually (p<0.05). Only 27% of men stated they would prefer HIV testing at a site other than the ANC. There was agreement between male and female reports for sociodemographic characteristics; however, men were more likely to report HIV preventive behaviors and health communication within the partnership than their partners (p<0.05).Conclusions/SignificanceOffering VCT services to men at antenatal clinic with options for couple and individual counseling is an important opportunity and acceptable strategy for increasing male involvement in PMTCT and promoting male HIV testing.

Highlights

  • Mother-to-child HIV transmission (MTCT) remains a significant problem in the developing world despite the development and growing availability of effective prevention methods appropriate for resource-limited settings

  • Voluntary HIV counseling and testing (VCT) in the context of antenatal care serves as the entry point for targeted prevention of MTCT, and a majority of pregnant women accept antenatal voluntary HIV counseling and testing (VCT) in these settings [1,2,3,4,5], many do not learn their HIV serostatus, take part in prevention programs, or implement interventions to reduce the risk of vertical HIV transmission [4,5,6,7,8,9,10,11]

  • Couple VCT was shown to have greater benefits than accompanying the female partner for individual VCT [3], and further analyses found that couple counseling was similar in terms of cost-effectiveness for preventing MTCT to standard antenatal VCT [16]

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Summary

Introduction

Mother-to-child HIV transmission (MTCT) remains a significant problem in the developing world despite the development and growing availability of effective prevention methods appropriate for resource-limited settings. Male partners play a role in women’s risk of acquiring HIV and in uptake of antenatal VCT and MTCT prevention programs [12,13,14,15]. We observed that the involvement of male partners in antenatal VCT was associated with increased uptake of interventions to prevent vertical and sexual HIV transmission [3]. Male partner involvement in antenatal voluntary HIV counseling and testing (VCT) has been shown to increase uptake of interventions to reduce the risk of HIV transmission in resource-limited settings. We aimed to identify methods for increasing male involvement in antenatal VCT and determine male correlates of accepting couple counseling in these settings

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