MALE PARTNER INVOLVEMENT IN THE PREVENTION OF MOTHER TO CHILD TRANSMISSION ON HIV IN LAGOS

Abstract

Several studies have shown that male partner involvement (MPI) in the PMTCT activities, couple counseling and testing for HIV increases use of intervention for HIV transmission prevention during pregnancy. Male partner involvement has the potential to bring about change because of the social power men hold in our society settings. Therefore, this study was conducted to determine the level of male involvement and to identify factors associated with male involvement in the PMTCT programme in Lagos State. The study was a facility based descriptive cross-sectional study using a multi-stage sampling technique to select 320 pregnant women assessing PMTCT services in secondary health facilities in Lagos state. A pretested, interviewer, administered questionnaire was used to collect data consisting of socio-demographic characteristics, self reported disclosure of HIV status to partner, and level of HIV related communications with partners. A male partner involvement index score was constructed using 7 structured questions. The questions were scored one point each. Scores between 0-4 were classified as low MPI and 5-7 as high MPI. Three focus group discussions were also conducted. Data were analysed using descriptive statistics such as means, standard deviations and proportions. The chi squared test and binary logistic regression were used to investigate the association between MPI and selected explanatory variables. All analyses were conducted at the 5% level of significance. The respondents had a mean age of 31 ± 4.6 years. Many (42.5%) were between age group 30- 34, 64.4% were Christians and majority was Yoruba (61.6%). Male partner involvement was 16.6%. Disclosure of HIV status to partners, having HIV related discussion and being on ARV before this current pregnancy were significantly associated with male partner involvement (p <0.05). Majority (60.9%) had been pregnant before this current pregnancy and 57.5% tested positive before this current pregnancy but only 55.3% had disclosed their HIV status to their partners with less than half the respondents 43.8% had ever discussed testing with their partners. Only 35.7% of the respondents reported HIV prevention discussion with partners, with about 43.8% respondents ever discussed testing with their partners. A total of 21.6% reported high level of HIV related discussion. Education, having been on ARV before the current pregnancy, having a positive partner and respondents who reported high level of HIV related discussion as well as high male involvements were significantly associated with disclosure of HIV status to partners at p <0.05. More than half of the respondents (68.4%) had been on ARV before this current pregnancy and 55.0% respondents reported complete adherence of ARV during this current pregnancy, having a previous positive child, good knowledge of HIV transmission and high level of male partner involvement were all significantly associated with adherence to ARV at p<0.05. Logistic regression showed disclosure of HIV status to partner (AOR= 4.0; 95% CI: 0.11-0.56) significantly predicted male partner involvement of PMTCT in Lagos state, being on ARV before current pregnancy (AOR = 4.30; C.I: 2.17 - 8.52) and high level of HIV discussion predicted disclosure as well as having a previous positive child and knowing father's status (AOR = 1.97; C.I: 1.04- 3.72) predicted adherence to ARV use. Level of male partner involvement, disclosure and adherence in PMTCT programme in Lagos state was low, and HIV related communication among partners was also low. This study also provides evidence that emphasis should be placed on disclosure among partners as well as HIV related communication among partners should be encouraged and the need for Lagos state to have programmes that will facilitate male partners' involvements as integration of male partners will strengthen all four pillars of PMTCT.