Amsterdam 2015
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| Abstract #2173 - Pregnancy and HIV | ||||
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Session: 14.3: Pregnancy and HIV (Symposium) on Wednesday @ 14.30-16.00 in C103 Chaired by Sibylle Niderost, Sandra Van Den Eynde Authors: Presenting Author: Ms Pamela Musoke - University of Alabama at Birmingham, United States |
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| Additional Authors: | ||||
| Aim: Adopting healthy behaviors related to prevention-of-mother-to-child-transmission (PMTCT) and maternal and child health (MCH) requires involvement of both members of a couple. Yet, little is known about how best to actively encourage male partners to support essential PMTCT and MCH activities. We explored men’s perceptions of couples HIV Testing and Counseling (CHTC) during pregnancy, and elucidated their perceptions of antenatal care, HIV testing, and their fears around HIV status disclosure and sero-discordance. | ||||
| Method / Issue: Forty in-depth interviews with 40 male partners of HIV-positive and HIV negative pregnant women were conducted in rural Migori County, Kenya. Interviews were transcribed verbatim and translated into English. Transcripts were analyzed using the Dedoose software program, in which authors used a thematic analysis approach. A structured coding framework was applied, followed by inductive fine coding process, grounded in the data. | ||||
| Results / Comments: Most male partners believed that participating together in both antenatal care and couples HIV testing and counseling were important, especially in maintaining trust among couples. A few men reported their regular participation in antenatal care (ANC) visits as a means of ensuring overall health of the family. However, several obstacles hindered most men’s ability to participate in ANC: participants reported being unaware of ANC appointments many said they were “too busy” or financially constrained to attend ANC operational hours also restricted how often working male partners could accompany their wives. A few male partners posited that men within their communities were also apprehensive about attending ANC clinics because of the perception that participating in ANC would force men into HIV testing. If tested HIV-positive, men feared being labeled as “victimizers” in situations of sero-discordancy, and vividly described their fears of being abandoned by their female partner due to perceived infidelity. Amidst these fears and obstacles to ANC visit participation, many men chose to use their pregnant partner’s HIV status as a proxy for their own HIV status. In other instances, men said that they staunchly refused to accompany their wives to clinic, using Luo culture as a rationale for avoiding the ‘effeminate’ act of clinic attendance. Indeed, many echoed the notion that the ANC clinic was no place for a man and accompanying spouses was a sign of male weakness. | ||||
| Discussion: Most male participants understood that antenatal care was important to maintaining the health of their families, but salient fears of negative consequences of HIV test results and gender role expectations hinder men’s uptake of ANC services. Current ANC services in this setting seem to ignore the practical and emotional needs of male partners, with some services actively excluding men by pressuring couples into HIV testing without providing the requisite psychological care needed to deal with sero-discordancy. Responding to these findings may assist future programs in engaging both men and women in PMTCT and uptake of essential MCH services. | ||||
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