Perceptions of Community Members and Healthcare Workers on Male Involvement in Prevention of Mother-To-Child Transmission Services in Khayelitsha, Cape Town, South Africa.

Alice Norah Ladur,Christopher J Colvin,Kathryn Stinson

doi:10.1371/journal.pone.0133239

Abstract

Involving male partners of pregnant women accessing PMTCT programs has the potential to improve health outcomes for women and children. This study explored community members’ (men and women) and healthcare workers’ perceptions of male involvement in the prevention of mother-to-child transmission of HIV in Khayelitsha, South Africa. Two focus group discussions were held with 25 men of unknown HIV status and one focus group discussion held with 12 HIV-positive women in the community. In depth interviews were conducted with four HIV-positive couples and five service providers purposely sampled from the community and a health facility, respectively. Both men and women interviewed in this study were receptive towards male involvement in PMTCT. However, men were reluctant to engage with health services due to stigma and negative attitudes from nurses. This study also found HIV testing, disclosure and direct health worker engagement with men increases male involvement in PMTCT. Using men in the media and community to reach out to fellow men with prevention messages tailored to suit specific audiences may reduce perceptions of antenatal care as being a woman`s domain.

Highlights

In South Africa, an estimated 5.6 million people were living with HIV in 2011, while AIDSrelated illnesses accounted for 35% of all deaths in children less than five years of age [1, 2].Prevention of mother-to-child transmission (PMTCT) offers a unique opportunity to reduce the number of HIV-related deaths in children under five years as well as serve as an entry point to HIV care for mothers and their families, promoting maternal and family health [3]
Voluntary HIV testing is provided to all pregnant mothers at first antenatal care (ANC) visit, all HIV positive women who are pregnant, breast feeding or within one year postpartum are initiated on lifelong ART irrespective of CD4 cell count
This study aimed to explore community members’ and healthcare workers’ perceptions of male involvement in PMTCT in order to provide insights into possible ways of increasing male partner participation in antenatal care and improve outcomes of pregnant women accessing PMTCT services

Summary

Introduction

In South Africa, an estimated 5.6 million people were living with HIV in 2011, while AIDSrelated illnesses accounted for 35% of all deaths in children less than five years of age [1, 2]. Prevention of mother-to-child transmission (PMTCT) offers a unique opportunity to reduce the number of HIV-related deaths in children under five years as well as serve as an entry point to HIV care for mothers and their families, promoting maternal and family health [3]. Similar to other African countries, South Africas PMTCT programme focuses on; voluntary HIV testing and counselling, antiretroviral treatment or prophylaxis for the mother and PLOS ONE | DOI:10.1371/journal.pone.0133239. Voluntary HIV testing is provided to all pregnant mothers at first antenatal care (ANC) visit, all HIV positive women who are pregnant, breast feeding or within one year postpartum are initiated on lifelong ART irrespective of CD4 cell count. Exclusive breast feeding is recommended for infants during the first six months [6]

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