Improving Men’s Participation in Preventing Mother-to-Child Transmission of HIV as a Maternal, Neonatal, and Child Health Priority in South Africa

Berg, Wessel van den; Brittain, Kirsty; Mercer, G. William; Peacock, Dean; Stinson, Kathryn; Janson, Hanna; Dubula, Vuyiseka

doi:10.1371/journal.pmed.1001811

Cited by 42 publications

(37 citation statements)

References 34 publications

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“…The findings of this study supported the study conducted in South Africa which revealed that the male partners who had high monthly income were more involved in PMTCT of HIV services than respondents who had low monthly income [1]. This low involvement might be due to lack of awareness about PMTCT service which are given free of fee in all governmental health facilities and sociodemographic characteristics of the respondents.…”

Section: Discussionsupporting

confidence: 84%

“…Mother-to-child transmission is the most common mode of human immunodeficiency virus (HIV) transmission in children which can be vertically transmitted from HIV positive pregnant women to their unborn babies during pregnancy, labour, and delivery or through breastfeeding after delivery [1–3]. HIV remains a major challenge globally regardless of decades of advocacy and investment in programs to control the spread of the virus [4, 5].…”

Section: Introductionmentioning

confidence: 99%

“…Uptake of PMTCT services by the pregnant mothers is affected both by factors related to the health system such as accessibility of voluntary counselling and testing (VCT) services and by individual factors such as fear of disclosure of HIV results, lack of male partner support, fear of domestic violence, rejection, and negligence [1, 5, 11–14]. In Ethiopia, mother-to-child transmission (MTCT) accounts for 95% of childhood HIV infections.…”

Section: Introductionmentioning

confidence: 99%

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Male Partners Involvement in Prevention of Mother-to-Child Transmission of HIV Services in Southern Central Ethiopia: In Case of Lemo District, Hadiya Zone

Belato

Beyamo

Begashaw

2017

AIDS Research and Treatment

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Male partners' involvement is a vital issue to prevent human immunodeficiency virus (HIV) transmission from mother to child; because it is much expectable that women were more vulnerable and high risk group of population portion. Therefore, to save lives of mothers and their newborn from acquiring HIV, male partners should do their maximum endeavor regardless of any determinant factors as our results revealed its status in our study context and elsewhere at past time too.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Male Partners Involvement in Prevention of Mother-to-Child Transmission of HIV Services in Southern Central Ethiopia: In Case of Lemo District, Hadiya Zone

Belato

Beyamo

Begashaw

2017

AIDS Research and Treatment

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“…We propose that safer conception activities be incorporated into evolving UTT implementation plans and targets since this would represent an efficient alternative to a lengthy parallel process of developing a standalone safer conception framework. Integration of safer conception activities into the UTT plans finds congruence with 90:90:90 goals given the potential impact safer conception services may have on HCT and ART uptake, adherence and client retention, and viral suppression, particularly amongst men [15,30,31]. …”

Section: Discussionmentioning

confidence: 99%

Supporting HIV prevention and reproductive goals in an HIV-endemic setting: taking safer conception services from policy to practice in South Africa

Davies

Matthews

Crankshaw

et al. 2017

Journal of the International AIDS Society

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Introduction: Safer conception care encompasses HIV care, treatment and prevention for persons living with HIV and their partners who desire children. In 2012, South Africa endorsed a progressive safer conception policy supporting HIV-affected persons to safely meet reproductive goals. However, aside from select research-supported clinics, widespread implementation has not occurred. Using South Africa as a case study, we identify key obstacles to policy implementation and offer recommendations to catalyse expansion of these services throughout South Africa and further afield.Discussion: Four key implementation barriers were identified by combining authors’ safer conception service delivery experiences with available literature. First, strategic implementation frameworks stipulating where, and by whom, safer conception services should be provided are needed. Integrating safer conception services into universal test-and-treat (UTT) and elimination-of-mother-to-child-transmission (eMTCT) priority programmes would support HIV testing, ART initiation and management, viral suppression and early antenatal/eMTCT care engagement goals, reducing horizontal and vertical transmissions. Embedding measurable safer conception targets into these priority programmes would ensure accountability for implementation progress. Second, facing an organizational clinic culture that often undermines clients’ reproductive rights, healthcare providers’ (HCP) positive experiences with eMTCT and enthusiasm for UTT provide opportunities to shift facility-level and individual attitudes in favour of safer conception provision. Third, safer conception guidelines have not been incorporated into HCP training. Combining safer conception with “test-and-treat” training would efficiently ensure that providers are better equipped to discuss clients’ reproductive goals and support safer conception practices. Lastly, HIV-affected couples remain largely unaware of safer conception strategies. HIV-affected populations need to be mobilized to engage with safer conception options alongside other HIV-related healthcare services.Conclusion: Key barriers to widespread safer conception service provision in South Africa include poor translation of policy into practical and measurable implementation plans, inadequate training and limited community engagement. South Africa should leverage the momentum and accountability associated with high priority UTT and eMTCT programmes to reinvigorate implementation efforts by incorporating safer conception into implementation and monitoring frameworks and associated HCP training and community engagement activities. South Africa’s experiences should be used to inform policy development and implementation processes in other HIV high-burden countries.

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“…Engaging men may also lead to gender-based violence, if couples are serodiscordant (34, 35). Given a lack of standardization of interventions and varying rigor in evaluation of impact, it is not surprising that both success and failure are reported, with uncertainties as to best practices and whether the added costs of male partner engagement have an evidence-based justification (8, 25, 36, 37). …”

Section: Introductionmentioning

confidence: 99%

Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique

et al. 2016

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Uptake of HIV testing and antiretroviral therapy (ART) services during antenatal care (ANC) in rural Mozambique is disappointing. To nurture supportive male engagement in ANC services, we partnered with Traditional Birth Attendants and trained a new type of male-to-male community health agent, “Male Champions”, who focused on counseling male partners to create new, male-friendly community norms around engagement in spousal/partner pregnancies. We assessed ANC service uptake using a pre-post intervention design. The intervention was associated with increases in: (1) uptake of provider-initiated counseling and testing among pregnant woman (81% vs. 92%; p<0.001); (2) male engagement in ANC (5% vs. 34%; p<0.001); and (3) uptake of ART (8% vs. 19%; p<0.001). When men accepted HIV testing, rates of testing rose markedly among pregnant women. With the challenges in scale-up of Option B+ in sub-Saharan Africa, similar interventions may increase testing and treatment acceptability during pregnancy.

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Improving Men’s Participation in Preventing Mother-to-Child Transmission of HIV as a Maternal, Neonatal, and Child Health Priority in South Africa

Abstract: Wessel van den Berg and colleagues outline how increasing male partner involvement in efforts to reduce mother-to-child HIV transmission in South Africa may improve maternal and infant outcomes.

Cited by 42 publications

References 34 publications

Male Partners Involvement in Prevention of Mother-to-Child Transmission of HIV Services in Southern Central Ethiopia: In Case of Lemo District, Hadiya Zone

Male Partners Involvement in Prevention of Mother-to-Child Transmission of HIV Services in Southern Central Ethiopia: In Case of Lemo District, Hadiya Zone

Supporting HIV prevention and reproductive goals in an HIV-endemic setting: taking safer conception services from policy to practice in South Africa

Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique

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