Attitude to counseling and testing for HIV and knowledge about prevention of mother to child transmission of HIV in men accompanying antenatal attendees at a tertiary care hospital in South India
Keywords:Attitude, Awareness, HIV testing, Male involvement, PPTCT
Background: Parent to child transmission is the second most common route of transmission of HIV in India contributing to 5% of new infections. This is due to underutilization of the components of PPTCT among pregnant women . As male partners remain the main decision makers in the family and influence their wife’s behaviour, poor awareness and negative attitude of men towards testing and treatment of HIV is a hindering factor in the successful implementation of the program. Therefore this study was carried out to study the awareness of men regarding HIV and PPTCT and also to assess their attitude towards testing and treatment in an antenatal clinic setting.
Methods: This is a cross sectional descriptive institution based study conducted in Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. The study participants were men who accompanied their pregnant wife to the antenatal clinic. A pretested, predesigned questionnaire was used as the survey tool to assess the knowledge of these men about PPTCT services and also to assess their attitude towards HIV testing during pregnancy. The collected data was entered in SPSS and analyzed using descriptive statistics.
Results: Among participants only 68% were aware that a HIV positive mother could transmit infection to her baby and more than half of the participants were not aware that breast feeding could cause vertical transmission. Nearly 39% of the participants were not aware that mother to child transmission can be curtailed by giving ART during pregnancy. Acceptance for HIV testing was fairly good even before pretest counseling to the extent of 88.6% of the participants. Among the participants who did not want to get tested for HIV, 52.9% assumed that their HIV status will be the same as that of their wife whereas 29.4% said that they were not comfortable undergoing the test along with their wife.
Conclusions: The present study shows that men lacked awareness about the concept of vertical transmission of HIV and also the various aspects of prevention of maternal to child transmission of the infection. Their attitude towards testing was positive even though they were not aware of its implications. Media should be used to create awareness and couple counseling and testing should be promoted in all PPTCT centers thereby increasing the male participation in the PPTCT program.
National AIDS Control Organization & ICMR- National institute of Medical statistics (2018). HIV estimations 2017: Technical report. New Delhi: NACO, Ministry of Health and Family welfare, Government of India.
NACO Annual report; 2012-13. Available from http://www.naco.gov.in/upload/publication/Annual % 20 Report/ Annual % 20 report % 20 2012-13 - English. pdf.
National AIDS control organization. Annual Report 2010-11. New Delhi, India: Department of AIDS control, Ministry of Health and family welfare, Govt of Ind. 2012.
Kumar A, Singh B, Kusuma YS. Counseling services in prevention of PMTCT in Delhi, India: An assessment through a modified version of UNICEF-PPTCT tool, J Epid Glob Health. 2015;5(1):3-13.
Shiradkar S, Mande S, Bapat G, Setia MS. Is it time to bring the parent into the prevention of parent to child transmission programs in India? A Study of trends over a 10 year period in a prevention of parent to child transmission clinic in India. Ind J Sex Transm Dis. 2016;37(1):58-64.
Katz DA, Kiarie JN, John-Stewart GC, Richardson BA, John FN, Farquhar C. Male perspectives on incorporating men into Antenatal HIV counseling and Testing. PLoS ONE. 2009;4(11):e7602.
Haile and Brhan. Male partner involvement is PMTCT: a cross sectional study, Mekelle. Northern Ethiopia. BMC pregnancy and child birth. 2014;14(1):65
Das, A, Babu GR, Ghosh P, Mahapatra T, Malmgren R, Detels R. Epidemiologic correlates of willingness to be tested for HIV and prior testing among married men in India. Int J STD AIDS. 2013;24(12):957-68.
Amano A, Musa A. Male involvement in PMTCT and associated factors among men whom their wives had AN visit 12 months prior to the study in Gondar Town, North west Ethiopia, Pan Afr Med J. 2016;24(1):239.
Byamugisha R, Tumwine JK, Semiyaga N, Tylleskär T. Determinants of male involvement in the prevention of mother to child transmission of HIV programme in Eastern Uganda: a cross sectional survey. Repr Health. 2010;7(1):12.
Zenebe A, Gebeyehu A, Derseh L, Ahamed KY. Male partner involvement in HIV counseling and testing and associated factors among partners of pregnant woman in Gondar Town, Northwest Ethiopia. J Preg. 2016(2);1-6
Nsagha D, Halle-Ekane G, Nfor C, Ngowe M, Nasah B. The role of the male partner in the prevention of mother to child transmission of HIV in Cameroon. Am J Epidem and inf Dis. 2014;2(2):52-9.
Nkuoh GN, Meyer DJ, Tih PM , Nkfusai J. Barriers to men’s participation in antenatal and prevention of mother to child HIV transmission care in Cameroon. Africa J Midwifery Womens Health. 2010;55(4):363-9.
Morfow F, Mbuagbaw L, Thabane L, Rodringues C, Wunderlich AP, Nana P, et al. Male involvement in prevention programmes of mother to child transmission of HIV : A systematic review to identify barriers and facilitators Syst Rev. 2013;2(1):5.
Falnes EF, Moland KM, Tylleskar T, De Paoli M, Msuya SE, Engebretsen IM. “It is her responsibility”; Partner involvement in prevention of MTCT of HIV programmes, Northern Tanzania. J Int AIDS Society. 2011;14(1):1-2.
Koo K, Makin J, Forsyth BW. Barriers to male participation in programs to prevent MTCT in South Africa. AIDS Edu and Prevent. 2013;25(1):14-24.
Kebaabetswe PM. Barriers to participation in prevention of mother to child transmission program in Gaborone, Botswana a qualitative approach. AIDS Care. 2007;19(3):355-60.
Osoti A, Han H, Kinuthia J, Farquhar C. Role of male partner in the prevention of mother to child HIV transmission. Res and Rep in Neonat. 2014;4:131-8.
O’Gorman DA, Nyirenda LJ, Theobald SJ. Prevention of MTCT of HIV infection: Views and perceptions about swallowing nevirapine in rural Lilongwe, Malawi, BMC Public Health. 2010;10(1):354-361.
Njunga J, Blystad A. The drone program : gendered experiences of HIV positive mothers enrolled in PMTCT programs the case of rural Malawi, Int Breast feeding J. 2010:5(1):14-9.
Okonkwo KC, Reich K, Alabi AI , Umeike N, Nachman SA. An evaluation of awareness: Attitudes and beliefs of pregnant Nigerian women towards voluntary counseling and testing for HIV, AIDS Patient Care and STDs. 2007;21(4):252-60.
Chigbu B, Onwere S. How do we improve male partner involvement in prevention of MTCT of HIV in Nigeria? Trop J Obstet and Gynaec. 2016;33(1):37-43.