Highlights
- Men desire to be involved in the elimination of mother to child transmission of HIV (EMTCT) using strategies that are acceptable to them
- An invitation to men to participate in related services will be the first step toward ensuring that they play a role in EMTCT.
- Male involvement (MI) increases communication between partners, which is crucial for addressing MTCT and other pressing health issues.
- In order to monitor and sustain MI, indicators demonstrating progress in male partner involvement in EMTCT must be included in the data collected.
Background
Men have an important role to play in ending mother-to-child transmission (MTCT) of the Human Immunodeficiency Virus (HIV). MTCT of HIV is preventable through early and regular antenatal care, HIV testing, treatment, and other measures. In 2021, 160,000 new HIV infections among children under the age of five were reported worldwide. To eliminate all new infections in children and cut HIV-related deaths in pregnant and breastfeeding women in half, HIV prevention and treatment must be accelerated for all. Male involvement (MI) in MTCT prevention can increase HIV testing and promote adherence to other preventive measures. This means that a man can influence a woman's chances of contracting HIV or passing it on to their child. It is therefore important to involve men in MTCT prevention so that they understand and perform their roles in transmission reduction more effectively. Despite this fact, male involvement remains low.
Research method
To learn how to increase male participation in EMTCT, we conducted various research studies. We began the research with a series of sequential exploratory studies. As a preferred strategy for involving men in the prevention of mother-to-child transmission (PMTCT), an invitation card informed by exploratory studies and validated by experts on its appropriateness was developed and tested for effectiveness in a randomized controlled trial. In 2013, 462 pregnant women without a male partner were randomly assigned to one of two groups: the invitation card group or the standard of care group.
Findings and conclusions
In our study, women in the invitation card group were nearly 50% more likely than women in the standard of care group to be accompanied by their male partners. We also discovered that male partners have an influence on intervention uptake along the PMTCT stages. Male partners were found to support the woman as she navigates the system and implements preventive and curative measures. Men benefited as well from the education they received as a result of their interactions with the healthcare system. In the absence of MI, HIV test results are not disclosed, and other PMTCT interventions are not implemented.
In conclusion, men will play an important role in ending MTCT because they influence the uptake of health interventions at the different important stages, and their absence leads to low uptake and poor adherence with prevention measures. A simple invitation card can help get more men to come to PMTCT services, which is good news.
Implications
PMTCT policy should include active male involvement strategies that are supported by indicators. Male inclusion must be comprehensive, encompassing both services available to support their partners and babies as well as measures to ensure that they remain actively involved. These supportive services could include antenatal clinics that offer fathers counseling and health education, as well as male-specific services like HIV testing, issues of men's health, and antiretroviral drug distribution. The policy should also attempt to assess the success of active male involvement strategies. This could be accomplished by collecting indicators such as the number of male partners who attend follow-up visits and the proportion of men who remain involved in antenatal care throughout their partner's pregnancy.
Recommendations
To increase the number of men who attend and participate in EMTCT efforts, health facilities should distribute invitation cards or increase their use.
PMTCT policies and guidelines should explicitly address male involvement.
Future research should focus on creating male friendly PMTCT services and evaluating their efficacy in EMTCT and improving men's health. In addition, the studies should aim to provide information on the acceptability, feasibility, and cost-effectiveness of potential male friendly PMTCT services.
Author
Alinane Linda Nyondo-Mipando1&2
1Department of Health Systems and Policy, Kamuzu University of Health Sciences, Blantyre, Malawi
2Department of Women’s and Children’s Health, University of Liverpool, UK
Main source of this article
Nyondo, A. L., Muula, A. S., & Chimwaza, A. F. (2013). Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi. Global Health Action, 6(1), 22780. https://doi.org/10.3402/gha.v6i0.22780
Nyondo, A. L., Chimwaza, A. F., & Muula, A. S. (2014). Exploring the relevance of male involvement in the prevention of mother to child transmission of HIV services in Blantyre, Malawi. BMC international health and human rights, 14, 1-12. https://doi.org/10.1186/s12914-014-0030-y
Nyondo, A. L., Choko, A. T., Chimwaza, A. F., & Muula, A. S. (2015). Invitation cards during pregnancy enhance male partner involvement in prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) in Blantyre, Malawi: a randomized controlled open label trial. PLoS One, 10(3), e0119273. https://doi.org/10.1371/journal.pone.0119273
Other references:
M’baya Kansinjiro, B., & Nyondo-Mipando, A. L. (2021). A qualitative exploration of roles and expectations of male partners from PMTCT services in rural Malawi. BMC Public Health, 21(1), 1-14.. https://doi.org/10.1186/s12889-021-10640-z
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