Will Your PartnerBe Attending?

Involving men in the prevention of mother to child transmission of HIV in antenatal care clinics

in Iringa, Tanzania

Kikumbih N; Motta W; Nielsen-Bobbit J; Mbandi A; Killian R; Mwanga F; Barone M; and Perchal P

EngenderHealthACQUIRE Tanzania Project

Objective

To explore the feasibility and impact of male involvement initiatives to increase male attendance and service utilization at PMTCT sites

Demographic Profile in Iringa

Population size Total population = 1,737,382 (2010 projection) WRA = 441,315

HIV/AIDS National HIV prevalence rate is 5.7% Iringa HIV prevalence is 16% Pregnant women HIV prevalence is 5%

Source: Tanzania DHS 2010; HIV survey 2008

Background

EngenderHealth’s ACQUIRE Tanzania Project (ATP) supports the MOHSW to increase access to and use of quality family planning and PMTCT services

More than 90% of women attending ANC are tested for HIV,yet most male partners are not informed of PMTCT services [UNAIDS, 2011]

Males have been traditionally seen as “facilitators” of their partners to access RH services [WHO, 2012]

Men accompanying their partners to ANC represents a key opportunity for engaging them in HIV and FP services

Why Male Involvement?

Men make a lot of the decisions regarding reproductive health (e.g., condom use) [WHO, 2012]

Male involvement can:– Reduce stigma and discrimination directed to HIV-

positive women (e.g., fear of HIV disclosure) – Improve treatment adherence [Farquhar et al, 2004]– Improve couple communication regarding sexuality

issues.

Male Involvement Interventions (2008 onwards)

Training Infrastructure Posters Invitation to men Men invited to ANC health talks Male friendly health services provided at ANC Couples given first priority for PMTCT services

Evaluation Methodology

Program data was collected monthly in all 351 sites providing PMTCT services between 2008 – 2011

Data collected included: – ANC attendance for women and men– HIV testing

EPI-INFO used for analysis

Results: Increased Male Involvement

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ANC visits without partnersANC visits with partner

Male Partners’ HIV Testing Trend

2008 2009 2010 2011

Partners tested 1,746 10,595 20,758 22,623

Partners tested HIV (+) 274 1,432 2,549 2,175

HIV prevalence 15.7% 13.6% 12.3% 9.6%

Ongoing Challenges

RH policies target women instead of couples

Provider bias and negative attitude about men’s participation in ANC and labor/delivery

Male involvement slow to pick-up despite interventions

Lessons Learnt

Local male involvement initiatives can encourage men to accompany their partners at ANC

Men are exposed to correct information on HIV and PMTCT through participation in health talks and couples counseling

Male involvement initiatives have contributed to more men getting tested for HIV, and those positive were referred to care and treatment

ACKNOWLEDGEMENT

PEPFAR MOHSW Districts – Council Health Management Teams (CHMTs) PMTCT sites staff Engender health Partners

Thank you