Men: A Key to Preventing Mother-to-Child Transmission – By Johanna Harvey

A couple in the Democratic Republic of Congo receive
prevention of mother-to-child transmission (PMTCT) counseling.
Male involvement is key to battling HIV and keeping mothers and
babies healthy. (Photo: James Pursey/EGPAF)
As we explore new ways to provide the treatment and education necessary to prevent mother-to-child transmission of HIV/AIDS (PMTCT), we need to look beyond services for pregnant women and mothers and include the crucial role male partners have in successful PMTCT programs.

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Studies have shown that male involvement in the prevention of mother-to-child transmission (PMTCT) services reduced the risks of vertical transmission (mother-to-child) and infant mortality by more than 40 percent. Educating male partners about HIV in general and how it is transmitted is essential to long-term approaches to eliminating HIV/AIDS transmission. A 2008 study by the University of North Carolina at Chapel Hill and South Africa’s University of KwaZulu Natal, found that male involvement in PMTCT was linked to more people taking advantage of HIV testing, antiretroviral treatment, condoms, and support for infant feeding choices.

However, societal norms still create barriers for health workers aiming to include more men in their programs. Research has found men’s beliefs about manhood are the strongest predictor of risk-taking behavior, such as unprotected sex and sex with multiple partners. Expectations that men should be more knowledgeable and experienced than women about sexual matters may prevent them from seeking information about sexual health problems. Stereotypes also put men and their partners at greater risk; for example, some men believe only promiscuous women carry condoms.

But the good news is there are programs in place to overcome these challenges. One example is the Zingatia Maisha project (a Swahili translation of „Positive Action“ that literally means „Carefully consider life“) in Kenya. It helps the medical establishment and communities affected by AIDS work together to develop a new model for the Greater and Meaningful Involvement of People Living with HIV/AIDS (GIPA) that achieves better HIV services and improved adherence to treatment. From 2005 through 2009, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) supported this program and helped secure the current system, which includes referral tools, HIV treatment literacy, and adherence counseling and support. In total, 38 health facilities in several counties across Kenya were supported to establish the project’s unique Health Facility/Community Linkage Committees (HCLCs). The HCLCs provided a forum for clinicians and other health workers to interact with their clients to improve on the quality of care.

In addition, the project focused on creating clinics exclusively for men, where they can go to receive counseling and education. HIV-positive men form support groups and both positive and negative men are counseled on the value of accompanying their partners for antenatal visits. The men also receive education on issues that are usually taboo for men such as the importance of exclusive breastfeeding for HIV-positive mothers. The counseling is also beneficial for HIV-negative men in discordant relationships because it provides them with the education to stay HIV-negative while supporting their HIV-positive partners.

By educating men on their important role in PMTCT and other HIV-prevention measures, we can also ensure that women gain more control over their sexual health and the health of their families.

Johanna Harvey is Senior Communications Officer for the Foundation, based in Washington, D.C.

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