The impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission of HIV on the uptake of safe infant feeding practices by HIV positive women in sub-Saharan Africa. A systematic review and meta-analysis

Fongwen, Noah; Atem, Jeannine A.; Aminde, Léopold Ndemnge; Malisheni, Moffat; Murewenhema, Grant

doi:10.1371/journal.pone.0207060

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…The findings of the present study are in line with prior studies that report a significant association between MPI and PMTCT outcomes. A series of systematic reviews examining studies from sub‐Saharan Africa by Takah et al 13,18‐20 indicated that MPI in PMTCT—typically conceptualized as a single isolated behavior such as male attendance at ANC—is associated with women's uptake of ART during pregnancy, 13 facility delivery, 18 safe infant feeding, 19 and uptake of infant HIV prophylaxis 20 . In a prospective cohort study, Aluisio et al 21 further found that MPI in PMTCT in the form of ANC attendance in Kenya resulted in increased HIV‐free survival of infants throughout the first year of life.…”

Section: Discussionmentioning

confidence: 99%

Male partner involvement and successful completion of the prevention of mother‐to‐child transmission continuum of care in Kenya

Hampanda

Helová

Odwar

et al. 2020

Intl J Gynecology & Obste

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Objective To examine the relationship between male partner involvement (MPI) in prevention of mother‐to‐child transmission (PMTCT) activities and successful completion of the PMTCT continuum of care, which remains sub‐optimal in settings with high prevalence of HIV. Methods A cross‐sectional survey was administered in June–August 2017 to a sample of 200 postpartum Kenyan women with HIV enrolled in a parent trial. Composite PMTCT and MPI variables were created. Descriptive, simple and multivariable regression, and mediation analyses were performed. Results Of the women, 54% reported successful completion of PMTCT. Depression and internalized HIV stigma were independently associated with lower likelihood of successful completion of PMTCT (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI] 0.94–0.99; aRR 0.92; 95% CI 0.88–0.98, respectively). Each MPI activity was associated with 10% greater likelihood of successful completion of PMTCT (P < 0.05). The relationship between MPI and the successful completion of PMTCT was partially mediated through women's reduced internalized HIV stigma (β −0.03; 95%CI −0.06 to −0.00). Conclusion Greater MPI in PMTCT activities has direct and indirect effects on women's successful completion of all necessary steps across the PMTCT continuum. Reduced internalized HIV stigma is likely a key mechanism in the relationship.

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Section: Discussionmentioning

confidence: 99%

Male partner involvement and successful completion of the prevention of mother‐to‐child transmission continuum of care in Kenya

Hampanda

Helová

Odwar

et al. 2020

Intl J Gynecology & Obste

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“…Men in Botswana regarded antenatal care (ANC) facilities as being "generally unfriendly" to them [ 9 ]. Most recently, a review of studies incorporating men suggested that male "support" as well as "involvement" are key to increasing PMTCT uptake [ 10 ]. The WHO 2010–2015 guidelines on PMTCT emphasize the need to involve male partners to scale up PMTCT services in sub-Saharan Africa [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia

et al. 2022

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Background Though antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery. Methods We conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted 28 in-depth interviews among women and 2 focus group discussions among male partners. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework. Results Men thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and, expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one’s children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women’s intrinsic motivation. Conclusion The results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men’s role in couples’ joint decision-making and women’s maternal love as motivators for adherence.

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“…While ensuring better coverage of ART for pregnant women, numerous systematic reviews interventions targeting factors that may influence their use of prevention of mother-to-child transmission (PMTCT) services are complementary to help reduce MTCT more quickly (Ambia & Mandala, 2016;Mutabazi et al, 2017; Organisation mondiale de la santé (OMS), 2013; Wettstein et al, 2012). Among these interventions, the involvement of pregnant women's partners in antenatal care and PMTCT has identified that it can improve outcomes of PMTCT programs in resource-limited settings such as uptake and adherence to ART during pregnancy and delivery, enhancement of HIV-free survival among children (Dunlap et al, 2014;Frederick Morfaw et al, 2013;Manjate Cuco et al, 2015; Organisation mondiale de la santé (OMS), 2012; Takah et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study

et al. 2021

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This mixed-methods study aimed to determine the level of male involvement in the prevention of mother-to-child transmission (PMTCT) services in Haiti and identify barriers and associated factors. From May to June 2018, a questionnaire was used to measure the level of male involvement. Semistructured interviews with pregnant women were also conducted. Multivariate linear regression and qualitative content analyses were performed to explore factors associated and barriers to male partners’ involvement in PMTCT services. One hundred and two pregnant women living with HIV completed the questionnaire. About 47% of male partners had a high level of involvement. Specifically, 90% financially supported their spouse, and 82% knew her appointment date at the antenatal clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and 19% routinely used a condom during sexual intercourse. Factors associated with male involvement in PMTCT were being married and sharing HIV status with the male partner. Male partners with a positive HIV status were more likely to be involved in PMTCT. Qualitative findings revealed that barriers to male involvement included the conflict between opening hours of the ANC and the male partner’s schedule, waiting time at the ANC, and the perception of antenatal care as being women’s business. Overall male partners’ involvement in PMTCT services is moderate. Gender relations, sociocultural beliefs, and care organization are likely to hinder this involvement. Developing and implementing contextually and culturally accepted strategies for male partners of pregnant women could contribute to strengthening their involvement in the PMTCT program.

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The impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission of HIV on the uptake of safe infant feeding practices by HIV positive women in sub-Saharan Africa. A systematic review and meta-analysis

Cited by 8 publications

References 31 publications

Male partner involvement and successful completion of the prevention of mother‐to‐child transmission continuum of care in Kenya

Male partner involvement and successful completion of the prevention of mother‐to‐child transmission continuum of care in Kenya

Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia

Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study

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