Track C: Epidemiology and prevention research

Submission category C44: Integrating STI, sexual and reproductive health, HBV and HCV
services in HIV-prevention programs
Title: Increasing male partner involvement in antenatal services for elimination of
mother-to-child transmission of HIV
Authors: Agnes Watsemba,1 Chris Derrick Opio,3 Kyapa Rose,5 Bright A Wandera,3 Joseph
Hayuni,1 Alison Mitchell LeFew,2 Rebecca M Flueckiger,2 Melanie Lopez,4 Erasmus Tanga3
1) RTI International, USAID/Uganda HIV and Health Initiatives in Workplaces Activity,
Kampala, Uganda
2) RTI International, Research Triangle Park, NC, USA
3) World Vision Uganda, USAID/Uganda HIV and Health Initiatives in Workplaces Activity
4) World Vision, Inc., Federal Way, WA, USA
5) Uganda Police Health Department
Background: Previous studies demonstrate a positive association between attendance by male
partners at antenatal care (ANC) visits and improved maternal health outcomes. Hence, the
elimination of mother-to-child transmission of HIV program in Uganda emphasizes male partner
involvement in ANC. However, male partner attendance in Uganda remains low (10.3%). To
increase male partner ANC attendance, a pilot was conducted in Mbale Police Health Center III,
where a male-partner-package aimed at engaging men in the ANC process was distributed.
This package includes: 1) education about pregnancy and nutrition with messages for both men
and women, 2) couples given priority in accessing ANC services, 3) medical check-ups for male
partners, and 4) male partner attendance at the examination of the pregnant partner. The
objective of this study was to determine if the male-partner-packages increased male partner
ANC attendance.
Methods: The male-partner-package was distributed to women who sought ANC services at
Mbale Police Health Center III from June to October 2017. Male partner attendance in this
intervention group was compared with male partner attendance in this same setting, prior to the
implementation, from June to October 2016. A multivariate logistic regression model was fit to
male partner participation, including receipt of the male-partner-package and additional
covariates. Variables were removed through a backwards stepwise approach until all indicators
were significant at the 5% level.
Results: The estimated regression relationship between male partner ANC attendance and
receipt of the male-partner-packages was significant. The estimated increase of partner
attendance associated with the male-partner-package receipt was 24% (4.9% vs. 29.3%,
p=0.000). Further, increased male partner attendance was significantly associated with the
fourth and fifth ANC visits (27%), increased gestation age (18%), and woman’s HIV positive
status (38%).
Conclusions: The study found evidence of association between male partner ANC attendance
and receipt of the male-partner-package, along with additional covariates. These results
suggest increased awareness of ANC visit attendance benefits among men may contribute to
an increase in male partner ANC involvement.