Involving both parents in HIV prevention during pregnancy and breastfeeding

Hanpin, Benjamin; Rosenberg, Nora E.; Mweemba, Oliver; Powers, Kimberly A.; Zimba, Chifundo; Maman, Suzanne; Kasaro, Margaret P.; Mollan, Katie R.; Stringer, Jeffrey S. A.

doi:10.2471/blt.17.200139

Cited by 15 publications

(16 citation statements)

References 12 publications

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“…A couples‐based framework may be useful to guide HIV prevention during pregnancy and breastfeeding [9]. When pregnant women know their HIV status and that of their partners, they can better understand their individual risks for HIV acquisition/transmission and access appropriate HIV prevention, care and treatment services.…”

Section: Resultsmentioning

confidence: 99%

Accelerating progress towards the elimination of mother‐to‐child transmission of HIV: a narrative review

et al. 2020

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Introduction Findings from biomedical, behavioural and implementation studies provide a rich foundation to guide programmatic efforts for the prevention of mother‐to‐child HIV transmission (PMTCT). Methods We summarized the current evidence base to support policy makers, programme managers, funding agencies and other stakeholders in designing and optimizing PMTCT programmes. We searched the scientific literature for PMTCT interventions in the era of universal antiretroviral therapy for pregnant and breastfeeding women (i.e. 2013 onward). Where evidence was sparse, relevant studies from the general HIV treatment literature or from prior eras of PMTCT programme implementation were also considered. Studies were organized into six categories: HIV prevention services for women, timely access to HIV testing, timely access to ART, programme retention and adherence support, timely engagement in antenatal care and services for infants at highest risk of HIV acquisition. These were mapped to specific missed opportunities identified by the UNAIDS Spectrum model and embedded in UNICEF operational guidance to optimize PMTCT services. Results and discussion From May to November 2019, we identified numerous promising, evidence‐based strategies that, properly tailored and adopted, could contribute to population reductions in vertical HIV transmission. These spanned the HIV and maternal and child health literature, emphasizing the importance of continued alignment and integration of services. We observed overlap between several intervention domains, suggesting potential for synergies and increased downstream impact. Common themes included integration of facility‐based healthcare; decentralization of health services from facilities to communities; and engagement of partners, peers and lay workers for social support. Approaches to ensure early HIV diagnosis and treatment prior to pregnancy would strengthen care across the maternal lifespan and should be promoted in the context of PMTCT. Conclusions A wide range of effective strategies exist to improve PMTCT access, uptake and retention. Programmes should carefully consider, prioritize and plan those that are most appropriate for the local setting and best address existing gaps in PMTCT health services.

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Section: Resultsmentioning

confidence: 99%

Accelerating progress towards the elimination of mother‐to‐child transmission of HIV: a narrative review

et al. 2020

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“…Easily: %(n) 83.3% (15) With di culty: %(n) 11.1% 2Not at all: %(n) 5.6% (1) Electricity in the home (yes): %(n) 100% (18) Cooking source mainly rewood (yes): %(n) 11.1% 2HIV-positive status (yes): %(n) 61.1% (11) Disclosed status (yes): %(n) 100% (18) Bene ts of ANC attendance All male partners recognised and endorsed the importance of accompanying their pregnant wives for ANC. Several of the men who attended ANC found that the experience provided them reproductive health education and the opportunity to learn more about how to look after their partners during pregnancy and how to prepare for the coming baby.…”

Section: Resultsmentioning

confidence: 99%

“…Male involvement is a key strategy to promote sexual and reproductive health in the context of HIV [1,2].…”

Section: Introductionmentioning

confidence: 99%

“why Would I Use a Condom When I Want to Have a Child?” Men’s Unmet Needs Regarding Sexual and Reproductive Health Information in the Context of HIV in Zambia

Matenga¹,

Zulu²,

Nkwema³

et al. 2020

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BackgroundAlthough health care providers are beginning to focus on men's roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men’s perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV. MethodsWe interviewed a convenient sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis.ResultsMen reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman's space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men’s sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area.ConclusionThere is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.

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“…Global leaders, such as the World Health Organisation (WHO), promote male partner involvement as a key strategy to improve PMTCT uptake and adherence [ 12 , 13 ]. Recent literature, including several systematic reviews, report that male partner involvement–typically conceptualised as male attendance at ANC or couple HIV testing and counselling (CHTC)–is associated with improvements in women’s engagement in PMTCT [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Support or control? Qualitative interviews with Zambian women on male partner involvement in HIV care during and after pregnancy

et al. 2020

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Background Efforts to promote male partner involvement in the prevention of mother-to-child transmission (PMTCT) may inadvertently exploit gender power differentials to achieve programme targets. Methods We explored women's relative power and perceptions of male partner involvement through interviews with postpartum Zambian women living with HIV (n = 32) using a critical discourse analysis. Results Women living with HIV reported far-reaching gender power imbalances, including low participation in household decision-making, economic reliance on husbands, and oppressive gendered sexual norms, which hindered their autonomy and prevented optimal mental and physical health during and after their pregnancy. When the husband was HIV-negative, sero-discordance exacerbated women's low power in these heterosexual couples. Male involvement in HIV care was both helpful and hurtful, and often walked a fine line between support for the woman and controlling behaviours over her. Inequities in the sexual divisions

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Involving both parents in HIV prevention during pregnancy and breastfeeding

Cited by 15 publications

References 12 publications

Accelerating progress towards the elimination of mother‐to‐child transmission of HIV: a narrative review

Accelerating progress towards the elimination of mother‐to‐child transmission of HIV: a narrative review

“why Would I Use a Condom When I Want to Have a Child?” Men’s Unmet Needs Regarding Sexual and Reproductive Health Information in the Context of HIV in Zambia

Support or control? Qualitative interviews with Zambian women on male partner involvement in HIV care during and after pregnancy

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