Background The benefits of male partner involvement in antenatal care (ANC)
and prevention of mother-to-child transmission of HIV (PMTCT) for maternal and
infant health outcomes have been well recognised. However, in many sub-Saharan
African settings, male involvement in these services remains low. Previous
research has suggested written invitation letters as a way to promote male
partner involvement. Methods In this implementation study conducted at three
study sites in southwest Tanzania, acceptability of written invitation letters
for male partners was assessed. Pre-study CVCT rates of 2–19 % had been
recorded at the study sites. Pregnant women approaching ANC without a male
partner were given an official letter, inviting the partner to attend a joint
ANC and couple voluntary counselling and testing (CVCT) session. Partner
attendance was recorded at subsequent antenatal visits, and the invitation was
repeated if the partner did not attend. Analysis of socio-demographic indices
associated with male partner attendance at ANC was also performed. Results Out
of 318 women who received an invitation letter for their partner, 53.5 %
returned with their partners for a joint ANC session; of these, 81 % proceeded
to CVCT. Self-reported HIV-positive status at baseline was negatively
associated with partner return (p = 0.033). Male attendance varied
significantly between the rural and urban study sites (p < 0.001) with rates
as high as 76 % at the rural site compared to 31 % at the urban health centre.
The majority of women assessed the joint ANC session as a favourable
experience, however 7 (75 %) of women in HIV-positive discordant or concordant
relationships reported problems during mutual disclosure. Beneficial outcomes
reported one month after the session included improved client- provider
relationship, improved intra-couple communication and enhanced sexual and
reproductive health decision-making. Conclusion Official invitation letters
are a feasible intervention in a resource limited sub-Saharan African context,
they are highly accepted by couple members, and are an effective way to
encourage men to attend ANC and CVCT. Pre-intervention CVCT rates were
improved in all sites. However, urban settings might require extra emphasis to
reach high rates of partner attendance compared to smaller rural health
centres
