Alemayehu M T, Haidar J
Goba Hospital, Oromia Health Bureau, Goba, Ethiopia.
S Afr Med J. 2017 Sep 22;107(10):864-870. doi: 10.7196/SAMJ.2017.v107i10.11371.
Antenatal care (ANC) is an entry point for the prevention of mother-to-child transmission (PMTCT), particularly when a man accompanies his spouse for voluntary counselling and testing (VCT), even though this seldom happens in Ethiopia.
To study the role of male partners in improving PMTCT/ANC, which is essential to prevent HIV/AIDS transmission in this country. Our study focused on identifying barriers for the low involvement in PMTCT/ANC among male partners whose spouses received ANC.
A total of 422 male partners in Goba town, Oromia regional state, Ethiopia, were recruited in September - October 2014 and enrolled by a systematic sampling method. A facility-based cross-sectional study and two focus group discussions (FGDs) were conducted. Binary logistic regression and odds ratios were calculated to ascertain sociodemographic and other important information compared with the outcome variable and PMTCT/ANC, while the findings of the FGDs were grouped according to the emerging themes and analysed manually by means of a thematic approach.
The percentage of male partners (22.7%) accompanying their spouses for HIV testing and counselling at antenatal clinics improved three-fold when an invitation letter was introduced as a new initiative to increase male participation. Individuals in the age group 15 - 29 years (adjusted odds ratio (AOR) 5.4, 95% confidence interval (CI) 1.66 - 17.85), and whose duration of marriage was ˂5 years (AOR 5.6, 95% CI 1.83 - 17.30), were more likely to be tested than their referent groups. Men without a higher education (AOR 0.1, 95% CI 0.02 - 0.50), who disagreed with legal enforcement (AOR 0.1, 95% CI 0.07 - 0.32), were less likely to be tested, while those who did not notify their partners (AOR 8.4, 95% CI 1.92 - 37.12) were more likely to use the service. Being busy, proxy testing, fears of testing HIV-positive, neglecting the importance of VCT, and inadequate knowledge about the PMTCT/ANC programme were other barriers that came to the fore in the FGDs.
Identified barriers have to be addressed, and helpful practices, such as using invitation letters to increase the uptake of the service by male partners, have to be instituted.
产前保健是预防母婴传播的切入点，特别是当男性陪同其配偶进行自愿咨询和检测时，尽管在埃塞俄比亚这种情况很少发生。
研究男性伴侣在改善母婴传播/产前保健中的作用，这对于在该国预防艾滋病毒/艾滋病传播至关重要。我们的研究重点是确定其配偶接受产前保健的男性伴侣在母婴传播/产前保健中参与度低的障碍。
2014年9月至10月，在埃塞俄比亚奥罗米亚州戈巴镇共招募了422名男性伴侣，并采用系统抽样方法进行登记。开展了一项基于机构的横断面研究和两次焦点小组讨论。计算二元逻辑回归和比值比，以确定与结果变量及母婴传播/产前保健相比的社会人口学和其他重要信息，而焦点小组讨论的结果则根据新出现的主题进行分组，并采用主题方法进行人工分析。
当引入邀请信作为增加男性参与度的新举措时，陪同配偶在产前诊所进行艾滋病毒检测和咨询的男性伴侣比例（22.7%）提高了两倍。15 - 29岁年龄组的个体（调整后的比值比[AOR]为5.4，95%置信区间[CI]为1.66 - 17.85）以及婚姻持续时间＜5年的个体（AOR为5.6，95%CI为1.83 - 17.30）比其参照组更有可能接受检测。未受过高等教育的男性（AOR为0.1，95%CI为0.02 - 0.50）、不同意执法的男性（AOR为0.1，95%CI为0.07 - 0.32）接受检测的可能性较小，而未告知其伴侣的男性（AOR为8.4，95%CI为1.92 - 37.12）更有可能使用该服务。忙碌、代理检测、担心检测出艾滋病毒呈阳性、忽视自愿咨询检测的重要性以及对母婴传播/产前保健项目了解不足是焦点小组讨论中凸显的其他障碍。
必须解决已确定的障碍，并制定有益的做法，例如使用邀请信来提高男性伴侣对该服务的利用率。
