Targeted HIV testing for male partners of HIV-positive pregnant women in a high prevalence setting in Nigeria

Abstract

BackgroundPartner HIV testing during pregnancy has remained abysmally low in sub-Saharan Africa, particularly in Nigeria. Males rarely attend antenatal clinics with their female partners, limiting the few opportunities available to offer them HIV testing. In this study, we evaluated the scale-up of the Healthy Beginning Initiative (HBI), a community-driven evidenced-based intervention to increase HIV testing among pregnant women and their male partners. Our objectives were to determine the: (1) male partner participation rate; (2) prevalence of HIV among male partners of pregnant women; (3) factors associated with HIV positivity among male partners of HIV-positive pregnant women.MethodsWe reviewed program data of expectant parents enrolled in HBI in Benue State, north-central Nigeria. During HBI, trained lay health workers provided educational and counseling sessions, and offered free onsite integrated testing for HIV, hepatitis B virus and sickle cell genotype to pregnant women and their male partners who participated in incentivized, church-organized baby showers. Each participant completed an interviewer-administered questionnaire on demographics, lifestyle habits, and HIV testing history. Chi-square test was used to compare the characteristics of HIV-positive and HIV-negative male partners. Simple and multivariable logistic regression models were used to determine the association between participants' characteristics and HIV positivity among male partners of HIV-positive women.ResultsMale partner participation rate was 57% (5264/9231). Overall HIV prevalence was 6.1% (891/14495) with significantly higher rates in women (7.4%, 681/9231) compared to men (4.0%, 210/5264). Among the 681 HIV-positive women, 289 male partners received HIV testing; 37.7% (109/289) were found to be HIV-positive. In multivariate analysis, older age (adjusted odds ratio [aOR]: 2.45, 95% confidence interval [CI]: 1.27–4.72 for age 30–39 years vs. <30 years; aOR: 2.39, CI: 1.18–4.82 for age ≥40 years vs. <30 years) and self-reported daily alcohol intake (vs. never (aOR: 0.35, CI: 0.13–0.96)) were associated with HIV positivity in male partners of HIV-positive women.ConclusionThe community-based congregational approach is a potential strategy to increase male partner HIV testing towards achieving the UNAIDS goal of 90% HIV screening. Targeting male partners of HIV-positive women for screening may provide a higher yield of HIV diagnosis and the opportunity to engage known positives in care in this population.

Prevalence of HIV infection among newly admitted students in Ebonyi State University, Abakaliki, Nigeria

“…Reports elsewhere have indicated a higher prevalence among these groups (17). The higher prevalence of HIV among females (0.29%) compared to their male counterparts (0.14%) in this study is supported by reports elsewhere (18). Several reasons have been adduced for the higher prevalence among females, including their vulnerabilities, often associated with poor economic and sociocultural status, shy attitude towards sex education, and abhorrence of sex outside marriage culminating in restriction of young girls from access to sexual health and HIV services.…”

Access to maternal-child health and HIV services for women in North-Central Nigeria: A qualitative exploration of the male partner perspective

“…In our study, 43% of 30 male partners interviewed reported never having tested for HIV. Without targeted interventions, proportions of men not/never tested for HIV are reported as approximately 97% in Nigeria [ 48 , 76 ] and between 35% and 95% in other African countries [ 77 ]. In addition to HIV knowledge, prior HIV testing facilitates male partner involvement in, and women’s access to PMTCT services [ 47 ].…”

Differences in maternal characteristics and pregnancy outcomes between syphilitic women with and without partner coinfection

“…In China, the prevalence of syphilis among MSM married to women was 17.9% [29]. Normally, partners found to be HIV- or HBV-positive ranged from 37.7 to 6.8% for infected pregnant women [30, 31]. However, the above prevalence varies by geographic regions and disease epidemiology.…”

“…The increased risk for adverse events in women with syphilis concordant partners may be partly attributable to coinfection in couples. In addition, late ANC, high nontreponemal titers, and inadequate treatment may also lead to adverse outcomes [9, 30, 37, 38].…”

“…The results of this study highlight the need for adequate treatment in pregnancies with syphilis infection to improve the outcomes, particularly when the serologic status of a woman’s partner is unknown or when the partner is known to be affected. Partner screening integrated with early ANC and complete treatment should be prioritized, as has been frequently suggested in previous studies [9, 30, 35–38].…”