Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil

Yeganeh, Nava; Kerin, Tara; Simon, Mariana; Nielsen‐Saines, Karin; Klausner, Jeffrey D.; Melo, Marineide; Fitter, Samantha; Gorbach, Pamina M.

doi:10.1177/0956462419845225

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Health workers in rural Kenya worry about being scrutinized, judged and held accountable by companions, though many welcome their practical help [39]. Remarkably, similar demand and supply barriers to male partner participation have been documented in countries as diverse as Iran, Brazil and Papua New Guinea [59][60][61].…”

Section: Theory Of Changementioning

confidence: 96%

Male partner participation in maternity care and social support for childbearing women: a discussion paper

Daniele

2021

Phil. Trans. R. Soc. B

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Male partners/fathers are key support persons for many childbearing women and their involvement in pregnancy, childbirth and the postpartum/postnatal period has beneficial effects on a wide range of outcomes related to maternal and child health and family wellbeing. Social support is implicated in the relevant causal pathway, but has received largely tangential attention in the public health literature. This discussion paper aims to reframe men's participation in maternity care as an opportunity to enhance their readiness and ability to provide social support to women, contributing to the debate on the definition and rationale for male partner involvement, and paving the way for further empirical work. I begin by presenting a theory of change illustrating the causal pathway leading from male partner participation, through the key intermediate step of social support, to improved health and wellbeing for women and children. I proceed by arguing that many people desire male partner participation in maternity care; however, in practice, this is often limited owing to cultural, social and institutional barriers. I use examples from the intervention literature to demonstrate how participation in care can boost men's motivation to support women and enhance their ability to do so by increasing their knowledge and skills. Finally, I draw up general implications for further male partner involvement programmes, suggesting that in order to achieve meaningful and sustainable gains, attention to design is crucial in order to avoid reinforcing patriarchal gender norms. Programmes should be implemented alongside other efforts to improve quality and promote woman-centred care. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.

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Section: Theory Of Changementioning

confidence: 96%

Male partner participation in maternity care and social support for childbearing women: a discussion paper

Daniele

2021

Phil. Trans. R. Soc. B

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“…Our research collaboration has focused on encouraging male partner involvement in prenatal care in Porto Alegre, consistent with WHO and Brazilian Ministry of health guidelines. 30,31 We have performed qualitative and quantitative investigations, 23,26 and have found individual, partnership, and systemic factors can facilitate men's decision to attend prenatal care and once men navigate these factors to attend prenatal care, they would be willing to receive STI testing, treatment, and immunizations. In Figure 2, we adapted a conceptual framework 32 that suggests individual and partner characteristics influence partnership dynamics, which in turn influence risk behaviors such as concurrency and condom use, and which are all ultimately associated with risk of HIVand other STIs.…”

Section: Discussionmentioning

confidence: 99%

“…We modified the existing guidance using motivators and barriers to prenatal care attendance identified in previous qualitative and quantitative work with male partners living in Porto Alegre for the purposes of this study. 23,26 For example, optimizing infant health was a large motivator for men to participate and this was emphasized in our counseling. Enrollment to partners was available until the time of women's delivery as maternal infection and/or reinfection up until the time of delivery could cause complications for infant's perinatal health.…”

Section: Designmentioning

confidence: 99%

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Diagnosis and treatment of sexually transmitted infections in male partners of pregnant women in Brazil

Yeganeh

Kreitchmann²,

Leng

et al. 2021

Int J STD AIDS

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Sexually transmitted infections (STIs) can adversely affect a woman’s pregnancy and the health of the developing fetus. The source of these infections may be the male sexual partner who remains under-diagnosed and un-treated due to a combination of lack of symptoms, decreased access to health care, and poor health-seeking behaviors. From September 2018 to November 2019, we offered a cohort of pregnant women (gestational age range: 4.6–41 weeks) clinic-based STI testing for HIV and syphilis (via lateral flow assay rapid tests) and for Neisseria (N.) gonorrhoeae, Chlamydia (C.) trachomatis, and Trichomonas (T.) vaginalis (via PCR-based testing) at Santa Casa Hospital and 10 affiliated prenatal clinics in Porto Alegre, Brazil. 400 women between the ages of 18 and 46 years (mean age: 27 years) enrolled and 24% were diagnosed with an STI. Each woman enrolled agreed to invite their male partners to clinic for the same panel of STI testing, and 255 men (64%) between the ages of 18 and 64 years (mean age: 29 years) attended clinic and all accepted full intervention. In these male partners, 40 (16%) were diagnosed with an STI including 22 (8.7%) testing positive for C. trachomatis, 15 (6%) for treponemal antibody (syphilis), 7 (2.8%) for T. vaginalis, 3 (1.2%) for N. gonorrhoeae, and 1 (0.4%) for HIV antibody. In our multivariate analysis, having symptoms of an STI (AOR 4.5, 95% CI 1.3–15.2) and arguing about jealousy (AOR 3.1, 95% CI 1.2–8.2) remained significantly associated with male diagnosis of an STI. Sexually transmitted infections are common in sexual partners of pregnant women in Brazil and should be addressed to prevent reinfection of pregnant women.

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“…A very low number of studies derived from South America compared to Africa, indicating male involvement might not be considered a high priority issue in maternal health care in that region. However, the limited literature emphasizes that the current level of male involvement is extremely low in South America (31,32), with strong gender norms being the most persistent barrier (33,34). The reason why until now very few programmes have focused on male involvement in South America might be related to the lower prevalence of HIV on the continent compared to Africa (30).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the concept 'male involvement in maternal health' by natural language processing and descriptive analysis.

Galle

Plaieser

Steenstraeten

et al. 2021

Preprint

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Introduction Experts agree that male involvement (MI) in maternal health (MH) is a multifaceted concept, but a universal definition is lacking, hampering comparison of findings and interpretation of the literature. This systematic review aims to examine the conceptualization of MI in MH globally and critically review commonly used indicators. Methods PubMed, Embase, Scopus, Web of Science and CINAHL databases were searched for quantitative literature (between the years 2000 and 2020) containing indicators or variables representing MI in MH, which was defined as the involvement, participation, engagement or support of men in all activities related to maternal health. Results After full text review, 282 studies were included in the review. Most studies were conducted in Africa (43%), followed by North America (23%), Asia (15%) and Europe (12%). Descriptive analysis and text mining analysis showed MI in MH has been conceptualised by focusing on two main aspects: psychosocial support and instrumental support for maternal health care utilisation. Differences in measurement and topics were noted according to continent with Africa focusing on HIV prevention, North America and Europe on psychosocial health and stress, and Asia on nutrition. One third of studies used one single indicator for assessing MI in MH and no common pattern of indicators could be identified. Antenatal care attendance was the most used indicator (40%) followed by financial support (17%), presence during childbirth (17%) and HIV testing (14%). Majority of studies did not collect data from men directly. Discussion Researchers often focus on a single aspect of MI in MH, resulting in the usage of a narrow and simplified set of indicators. Aspects such as communication between the couple, shared decision making, participation in household tasks and the subjective feeling of being supported have received little attention. We believe a more multidimensional approach can broaden the potential of MI programs. Further research, involving experts and pilot testing, is recommended to develop consensus regarding a more robust and comprehensive set of valid and feasible indicators for assessing MI in MH.

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Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil

Cited by 6 publications

References 27 publications

Male partner participation in maternity care and social support for childbearing women: a discussion paper

Male partner participation in maternity care and social support for childbearing women: a discussion paper

Diagnosis and treatment of sexually transmitted infections in male partners of pregnant women in Brazil

A systematic review of the concept 'male involvement in maternal health' by natural language processing and descriptive analysis.

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