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

Abstract

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.

Effect of male partners' involvement and support on reproductive, maternal and child health and well‐being in East Africa: A scoping review

“…Several studies reported that such factors were found to impact nevirapine uptake, ART treatment adherence, PMTCT continuum adherence, condom use, facility‐based childbirth, receive HIV test results, HIV self‐testing, postpartum HIV status, infant HIV acquisition through MTCT, MTCT knowledge and uptake of family planning. 16 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 (Supporting Information S1: Table 3 ) For example, women with partners who were involved in HIV testing, counseling or other PMTCT activities were more likely to: return for follow‐up to receive nevirapine 86 ; take maternal or infant dose of nevirapine 86 ; adhere to Option B plus ART treatment 87 ; successfully complete all steps in the PMTCT continuum 88 ; and, show improved retention in HIV care. 89 Postpartum women with a partner who ever refused the use of a condom were more likely to have a positive HIV status (Adjusted Odds Ratio = 1.88; 95% confidence interval 1.20, 2.90) compared to women with a partner who never refused.…”

A cluster randomized trial to reduce HIV risk from outside partnerships in Zambian HIV-Negative couples using a novel behavioral intervention, “Strengthening Our Vows”: Study protocol and baseline data

“…This is similar to our own findings with Rwandan couples [ 91 ]. Other studies have focused on couples with one or both partners HIV+ [ [92] , [93] , [94] , [95] , [96] ] and have examined patterns of communication in couples and enhanced male involvement in HIV prevention with pregnant women [ [97] , [98] , [99] , [100] ], though without a specific focus on negotiated agreements [ 51 , [101] , [102] , [103] , [104] ].…”

Current state of prevention of mother-to-child transmission of HIV in informal health centers in Douala and Ebolowa, Cameroon

“…A total of 183 HPs were enrolled in the study, with the median age of 37 years (IQR, [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. Less than a quarter (19%) were male.…”

“…testing of male partners of pregnant women is a relevant strategy to increase the use of PTMCT services [38][39][40].…”