Table 2.
Data extraction of studies of male involvement in HIV and pregnancy
| Study | Intervention | Female participants | Male outcomes | Male partner attendances associations |
|---|---|---|---|---|
| Aluisio et al. [39] | HIV-positive pregnant women encouraged to invite partners to participate in antenatal care. Provision of HIV testing (Kenya) | 456 female participants | 140 male partners attended (31%) | Male attendance associated with monogamy, previous testing, discussions. Continuing to use services not associated. Male testing and discussion associated with formula feeding. Lower amount of infants acquiring HIV (40% reduction) |
| Ditekemena et al. [41] | Pregnant women attending an antenatal clinic were given an invitation for their male partner for HIV counselling and testing (VCT) Democratic Republic of Congo (DRC) | 2706 female participants. Randomized control trial (RCT) (health centre bar or church) for partner VCT | 591 male partners attended (22%), significantly higher in non-healthcare settings (bars) | Not measured |
| Mohlala et al. [46] | All pregnant women were given an invitation for their male partner to join either a PIS or VCT (South Africa) | 1000 female participants. RCT to two conditions (VCT or PIS) | Significantly more male partners attended VCT session (35%) than PIS (26%). 32% vs. 11% tested for HIV. Significant effects of VCT group on unprotected sex in pregnancy. | No effects on intimate partner violence. Reduced unprotected sex in pregnancy associated with VCT group. |
| Msuya et al. [40] | Pregnant women attending vertical transmission treatment were encouraged to inform and invite male partners for HIV-VCT (Tanzania) | 2654 female participants | 332 male partners (12.5%) attended HIV-VCT | Higher uptake of ART with partner participation (91% vs. 74%), avoidance of breastfeeding (19% vs. 6%) and infant testing uptake. |
| Katz et al. [37,38] | Women attending an antenatal clinic were asked to invite their partners to VCT (Kenya) | 2104 female participants | 1993 women requested male partner attendance; 313 (16%) men attended, 183 individual VCT. | Male ANC testing did not relate to disclosure. |
| Farquhar et al. [42] | Women attending an antenatal clinic were encouraged to return with their male partners for VCT and were offered couple posttest counselling (Kenya) | 2104 female participants | 308 male partners participated in VCT (15%), of whom 116 were couple counselled (38%) | HIV prevalence was lower among women whose partner attended clinic. Partner involvement associated with threefold increase of Nevirapine use, breastfeeding avoidance and condom use. |
| Oladokun et al. (2010) [57] | Women attending antenatal clinics (Nigeria) were encouraged to invite their partners for HIV testing via word of mouth. | 51,952 female participants (51,614 accepted HIV testing) | 361 (16.7%) male participants accepted HIV testing | Not measured |
| Byamugisha et al. [47] | Women attending an antenatal clinic in eastern Uganda were either given a written invitation (intervention) or an information sheet (control) to see which partners would attend the clinic and be HIV tested | 1060 female participants (530 in each group). Letter to spouse (invitation vs. information) | Attending the clinic – 86 male partners in the intervention attended (16.2%) and 75 in the control group attended (14.2%) HIV testing – 82 of the 86 male partners in the intervention group were tested (95%) and 68 out of 75 men were tested in the control group (91%) | Not measured |
| Desgrées-Du-Loû et al. [27] | HIV-positive, HIV-negative and women who refused an HIV test were offered prenatal counselling and HIV testing in Cote d'Ivoire. All female participants were encouraged to suggest HIV testing to their partner (Cote d'Ivoire) | 710 female participants – 306 HIV-positive women, 352 HIV-negative women and 52 untested women | 41 women had male partners tested (26 HIV-positivewomen, 14 HIV-negative and 2 refusers). Of male partners previously untested: 25% of women living with HIV, 13% HIV-negative women and 6% of previously untested tested for HIV. | High level of communication (irrespective of HIV status), and increased condom use on sex resumption after delivery. |
| Brou et al. (2007) [58] | Women attending antenatal care had an HIV test in Cote d'Ivoire were suggested to encourage partners to take a HIV test. Over the next two years, disclosure to their partner and the partner having an HIV test was measured. | 939 female participants – 545 tested positive and 393 tested negative | Two-year follow-up: 96.7% of women who tested negative disclosed to partner vs. 46.2% who tested positive. 23.1% of male partners of HIV negative women test vs. 14.8% of HIV-positive women. Male partners of HIV-positive women who disclosed status more likely to test (37.7% vs. 10.5%) | Not measured |
| Conkling et al. [45] | Two clinics (Rwanda and Zambia) compared mother and couple testing. Couples were tested when the woman chose to attend with partner. All women received invitation letter to either couple or antenatal testing. | 1940 women enrolled in Kigali (984 VCT, 956 couples' voluntary counselling and testing [CVCT]) and 1685 women enrolled in Lusaka (1022 VCT, 663 CVCT). 1619 couples tested, 2006 women alone. | HIV prevalence (14%). CVCT associated with reduced loss to follow-up: Kigali, 31% couples vs. 36% (p=0.011); and Lusaka, 22% couples vs. 25% (p=0.137). HIV-positive women with follow-up, CVCT had no impact on nevirapine use (86% to 89% in Kigali; 78% to 79% in Lusaka). | Partner participation was not associated with differences in nevirapine use. |
| Homsy et al. [43] | Antenatal and postpartum HIV testing of women and accompanying male partners (no specific invitation described). (Uganda) | 3591 pregnant women and 104 male tested (2.9%). Postpartum, 522 women tested, and 176 males. | Only 2.9% women had male partners tested in the antenatal clinic (ANC), 25% on the maternity ward. 48% (51/107) ANC couple counselling, 72% (130/180) in the maternity ward. Couples counselled together 2.8% of all persons tested in ANC, 37% of the maternity ward. | Not measured |
| Sherr et al. [44] | HIV test uptake in antenatal care over two time periods. (United Kingdom) | 3560 women, (2710 in 2002; 850 in 2004). | 0.6% partners offered HIV test. | Not measured |
ART, antiretroviral treatment; PIS, pregnancy information session.