A Qualitative Exploration of the Meaning and Understanding of Male Partner Involvement in Pregnancy-Related Care Among Men in Rural South Africa

Male partner involvement (MPI) during antenatal care has been promoted as an effective intervention to improve maternal and newborn health outcomes. Although MPI is commonly defined as men attending antenatal clinic visits with their female partner, few men attend antenatal clinic visits in rural communities in the province of Mpumalanga, South Africa. The study aimed to qualitatively explore the meaning and understanding of MPI as perceived by men visiting primary health care clinics in rural communities in Mpumalanga. Six focus groups discussions (n = 53) were conducted, digitally recorded, simultaneously transcribed, and translated verbatim into English. Data were analyzed using thematic content analysis. Perceptions of male roles during and after pregnancy differed among men. Male involvement was understood as giving instrumental support to female partners through financial help, helping out with physical tasks, and providing emotional support. Accompanying female partners to the clinic was also viewed as partner support, including behaviors such as holding a spot for her in the clinic queues. Community attitudes, traditional beliefs, and negative experiences in health facilities were barriers for MPI. This study provides support for concerted efforts to work with both men and women within the cultural context to explore the important roles of all members of the family in working together to provide the best possible health outcomes for mother and infant. In particular, future interventions should focus on making antenatal care services more responsive to male partners, and improving male partner accessibility in health care facilities

Prevalence and factors associated with fixed-dose combination antiretroviral drugs adherence among HIV-positive pregnant women on option B treatment in Mpumalanga Province, South Africa

The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers’ adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected at 12 community health centres, over 12 months (2014–2015), from 673 HIV-positive women, less than 6 months pregnant, attending antenatal care, and on Option B treatment. Adherence measures included the Adults AIDS Clinical Trials Group (AACTG) four-day measure, as well as the Visual Analog Scale (VAS) seven-day measure. Bivariate analyses and multivariate logistic regressions are presented. 78.8% of respondents were adherent on AACTG, while 68.8% reported VAS adherence. Bivariate analyses for increased adherence show significant associations with older age, less/no alcohol usage, disclosure of HIV status, higher HIV knowledge, no desire to avoid ARV side effects, low stigma, and low depression. AACTG showed a negative association with intimate partner violence. Multivariable logistic regression on AACTG and VAS adherence rates resulted in unique contributions to increased adherence of older age, less/no alcohol usage, higher HIV knowledge, lack of depression, and non-disclosure. Programs targeting closer side effect monitoring, HIV disclosure, pre-natal depression, alcohol intake, and HIV knowledge need consideration

HIV Prevention among Zambian Itinerant Workers: Challenges and Solutions

Mobility and alcohol abuse increase vulnerability to HIV among itinerants in Zambia. Itinerants face unique challenges to accessing HIV counselling, testing, and treatment. Zambian districts (Chingola, Mazabuka, Mufulira) were selected, and focus group discussions (FGDs = 12; n= 72) and key informant interviews (n = 71) were held. HIV risk and strategies to address barriers and facilitators of condom use, voluntary counselling and testing (VCT) and HIV-treatment were explored. Mobility increased sexual networks. Local bars, lodges, and truck stops were locations for sexual solicitation. Cheap lodgings were hot spots for HIV risk behavior. Difficulty accessing condoms and HIV treatment due to transience placed itinerants at elevated risk. Lack of clinics in rural areas further exacerbated itinerant risk. Initiatives to reduce these risks included implementation of border-clinics and employer-driven medical support for itinerants. Uptake of HIV prevention tools, health-education initiatives supporting itinerants, as well as health-care initiatives tailored to itinerant needs, are needed