Male Partner Linkage to Clinic-Based Services for Sexually Transmitted Infections and Human Immunodeficiency Virus Services Following Couple Home-Based Education and Testing

Abstract

Background Home-based human immunodeficiency virus (HIV) testing and education has increased HIV test uptake and access to health services among men. We studied how a home-based antenatal intervention influenced male partner utilization of clinic-based HIV and sexually transmitted infection (STI) services, linkage to HIV care and medical circumcision. Methods We conducted a secondary analysis within a randomized controlled trial of pregnant women attending antenatal care in Kenya. Women and their male partners received either a home-based couple intervention or an invitation letter for clinic-based couple HIV testing. The home-based intervention included education on STI symptoms, STI and HIV treatment and male circumcision for HIV prevention. Male self-reported outcomes were compared using relative risks at 6 months postpartum. Results Among 525 women, we reached 487 (93%) of their male partners; 247 men in the intervention arm and 240 men in the control arm. Men who received the intervention were more likely to report an STI consultation (n = 47 vs. 16; relative risk, 1.59; 95% confidence interval, 1.33–1.89). Among 23 men with newly diagnosed HIV, linkage to HIV care was reported by 4 of 15 in the intervention (3 men had missing linkage data) and 3 of 5 men in the control arms (relative risk, 0.66; 95% confidence interval, 0.34–1.29). Although the intervention identified 3 times more men with new HIV infection, the study lacked power to find significant differences in linkage to HIV care. Few eligible men sought medical circumcision (4 of 72 intervention and 2 of 88 control). Conclusions Home-based couple education and testing increased STI consultations among male partners of pregnant women, but appeared insufficient to overcome the barriers involved in linkage to HIV care and medical circumcision.

Understanding effective post‐test linkage strategies for HIV prevention and care: a scoping review

“…A US‐based quasi‐experimental study showed increased PrEP referral in the post‐intervention period among MSM receiving streamlined service delivery after post‐screening risk assessment [34]. In a Kenya‐based cohort study that involved contacting male partners of female ANC attendees, there was no improvement in VMMC linkage, though STI consultations were higher compared to the standard of care [35].…”

“…Gaps in WHO recommendations on linkage to prevention are summarized in Table 7. Studies conducted in Africa were all among heterosexual individuals and focused on linkage to PrEP, VMMC, STI and cervical cancer screening [26,28,29,31,33,35]. USbased studies evaluated PrEP linkage among key populations [27,30,32,34].…”

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

“…Given the low incidence of HIV in CNC after CVCT, cost-benefit analyses preclude PrEP in this group. Similarly, given limited access and low uptake in many areas [ [72] , [73] , [74] ] men in concordant HIV- unions would be a lower programmatic priority for male circumcision compared with single men or men with HIV + spouses.…”

Ações De Educação Em Saúde Sobre Sífilis Para Gestantes: Revisão Integrativa

“…No processo de construção da revisão integrativa, seis fases foram utilizadas: 1. ferramenta para a educação em saúde 17,19 ; uma utilizava mensagens de texto 18 ; e outra usava materiais educativos 20 .…”

“…Além disso, as intervenções expostas pelos estudos nem sempre eram retratadas de maneira isolada, em que, apenas um estudo tratava puramente da intervenção 18 ; dois traziam a intervenção educativa como uma das fases de um programa de intervenção 17,19 ; e um avaliava os materiais educativos 20 . Organizou-se um quadro para que as informações acerca estudos pudessem ser sintetizadas (Quadro 1).…”