Male partner involvement in the prevention of mother-to-child

Male partner involvement in the prevention of mother-to-child transmission (PMTCT) services reduced the risks of vertical transmission and infant mortality by more than 40% compared to no involvement according to Adam Aluisio and colleagues in a prospective cohort study undertaken between 1999 and 2005 in Nairobi, Kenya published in the January 1st 2011 edition of the Journal of Acquired Immune Deficiency Syndromes.

Male involvement, the authors add, may be an underutilised public health intervention to address both infant HIV infection and mortality in resource-poor settings.

90% of the estimated 1,000 children infected daily with HIV live in sub-Saharan Africa. Vertical transmission accounts for approximately 95% of infections in children.

Even though access to antiretrovirals for PMTCT has improved, much more remains to be done in resource-poor settings. Over one-third of HIV-infected pregnant women and half of their infants do not get any treatment.

Infant mortality rates in sub-Saharan Africa are the highest in the world. HIV transmission, infant feeding practices as well as poverty contribute to this, note the authors. While there is evidence of diminishing vertical transmission rates, infant mortality remains high. Improved infant health outcomes necessitate addressing these public health problems together, they add.

Evidence shows that male involvement is associated with better use of PMTCT services. However, the authors note there is scant evidence of the link between male involvement and rates of vertical transmission or infant mortality.

From 1999 to 2002 HIV-infected pregnant women were recruited from antenatal clinics in Nairobi, Kenya and followed with their infants for one year. HIV DNA testing was done at birth and then at one, three, six, nine and 12 months after birth. Women were encouraged to bring their male partners for HIV prevention counselling and testing.

Out of a total of 510 HIV-infected women enrolled, a total of 10% (54) were lost to follow-up before delivery (27) or did not report a current male partner relationship (27).

Of the remaining 456 female participants, 140 (31%) were accompanied by their male partners to the antenatal clinic.

Of the 140 male partners, 75 (54%) were tested for HIV in the antenatal clinic; 42 (56%) tested positive.