BackgroundMany factors contribute to an enhanced risk of infant HIV acquisition, two of which may include failure of a mother to disclose her HIV-positive status to her partner and exclusion of male partners in preventing mother-to-child transmission of HIV (PMTCT) interventions. To justify why HIV programmes need to integrate male partner involvement and partner disclosure, we need to establish an association between the two factors and infant HIV acquisition.ObjectiveTo determine whether failure to disclose an HIV-positive status to a male partner is associated with increased risk of infant HIV acquisition, and whether part of the association is explained by exclusion of male partner in PMTCT programmes.MethodsUsing a case–control study design, we identified a total of 180 mother–baby pairs with HIV-exposed infants. Thirty-six pairs with HIV-positive babies (cases) were compared to 144 pairs with HIV-negative babies (controls) on whether the mothers had disclosed their HIV status to their partner in order to determine whether a disclosure or lack of it contributed to increased risk of mother-to-child transmission of HIV (MTCT). Each case pair was matched to four control pairs from the same facility.ResultsOverall, 16.7% of mothers had not disclosed their HIV status to their partners, the proportion being significantly more among cases (52.8% vs. 7.6%, p < 0.001). Non-disclosure was significantly associated with infant HIV acquisition (aOR 9.8 (3.0–26.3); p < 0.001) and male partner involvement partially mediated the effect of non-disclosure on infant HIV acquisition (indirect coefficient = 0.17, p < 0.005).ConclusionsFailure of an HIV-positive woman to disclose her status to her male partner and exclusion of male partners in PMTCT programmes are two social factors that may curtail success of interventions towards the goal of eliminating MTCT.

When male partners of pregnant women living with HIV do not participate in antenatal care, it decreases the uptake of prevention of mother-to-child transmission interventions, which increases the risk of HIV transmission to newborns. We evaluated the association of male partner involvement and vertical HIV transmission at 6 weeks along 4 constructs: antenatal clinic accompaniment, mother's awareness of partner HIV status, disclosure of mother's HIV status to partner, and couple testing. Thirty-three HIV-exposed infants with positive 6-week polymerase chain reaction (PCR) results were compared with 144 HIV-exposed infants with a negative PCR. Mothers of PCR-negative infants were 14 times more likely to have disclosed their HIV status to their partners (odds ratio [OR] = 14.1 [5.0–39.4]), to be aware of partner HIV status (OR = 0.2 [0.1–0.96]), and to have been accompanied by their male partners to the antenatal clinic (OR = 0.6 [0.5–0.9]). There is a need for male engagement in prevention of mother-to-child transmission programs.

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Developing ethical competence in nursing is integral to the process of professional socialisation during which students are taught the ethical values and norms of the nursing profession. The process of professional socialisation is however influenced by a range of factors related to the teaching and learning environment, such as organisational culture, teaching practices and role models. Students at a military nursing college are exposed to a unique environment rich in military culture. The findings discussed in this article formed part of a larger grounded theory study that aimed to determine the influence of the hidden curriculum on the professional socialisation of students in a military context. Data were collected from purposefully selected nurse educators and students by means of focus-group interviews and critical incident narratives. Findings revealed a significant influence of the abuse of rank on the ethical competence of students.