Florida International University Robert Stempel College of Public Health & Social Work, Miami, FL, United States of America.
Department of Community Medicine, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria.
PLoS One. 2019 Jan 30;14(1):e0211022. doi: 10.1371/journal.pone.0211022. eCollection 2019.
Partner HIV testing during pregnancy has remained abysmally low in sub-Saharan Africa, particularly in Nigeria. Males rarely attend antenatal clinics with their female partners, limiting the few opportunities available to offer them HIV testing. In this study, we evaluated the scale-up of the Healthy Beginning Initiative (HBI), a community-driven evidenced-based intervention to increase HIV testing among pregnant women and their male partners. Our objectives were to determine the: (1) male partner participation rate; (2) prevalence of HIV among male partners of pregnant women; (3) factors associated with HIV positivity among male partners of HIV-positive pregnant women.
We reviewed program data of expectant parents enrolled in HBI in Benue State, north-central Nigeria. During HBI, trained lay health workers provided educational and counseling sessions, and offered free onsite integrated testing for HIV, hepatitis B virus and sickle cell genotype to pregnant women and their male partners who participated in incentivized, church-organized baby showers. Each participant completed an interviewer-administered questionnaire on demographics, lifestyle habits, and HIV testing history. Chi-square test was used to compare the characteristics of HIV-positive and HIV-negative male partners. Simple and multivariable logistic regression models were used to determine the association between participants' characteristics and HIV positivity among male partners of HIV-positive women.
Male partner participation rate was 57% (5264/9231). Overall HIV prevalence was 6.1% (891/14495) with significantly higher rates in women (7.4%, 681/9231) compared to men (4.0%, 210/5264). Among the 681 HIV-positive women, 289 male partners received HIV testing; 37.7% (109/289) were found to be HIV-positive. In multivariate analysis, older age (adjusted odds ratio [aOR]: 2.45, 95% confidence interval [CI]: 1.27-4.72 for age 30-39 years vs. <30 years; aOR: 2.39, CI: 1.18-4.82 for age ≥40 years vs. <30 years) and self-reported daily alcohol intake (vs. never (aOR: 0.35, CI: 0.13-0.96)) were associated with HIV positivity in male partners of HIV-positive women.
The community-based congregational approach is a potential strategy to increase male partner HIV testing towards achieving the UNAIDS goal of 90% HIV screening. Targeting male partners of HIV-positive women for screening may provide a higher yield of HIV diagnosis and the opportunity to engage known positives in care in this population.
在撒哈拉以南非洲，尤其是在尼日利亚，伴侣 HIV 检测在怀孕期间仍然低得令人震惊。男性很少与女性伴侣一起参加产前检查，这限制了为他们提供 HIV 检测的机会。在这项研究中，我们评估了 Healthy Beginning Initiative（HBI）的扩展情况，HBI 是一项以社区为基础的循证干预措施，旨在增加孕妇及其男性伴侣的 HIV 检测。我们的目标是确定：（1）男性伴侣参与率；（2）孕妇男性伴侣的 HIV 流行率；（3）与 HIV 阳性孕妇的男性伴侣 HIV 阳性相关的因素。
我们回顾了在尼日利亚中北部贝努埃州参加 HBI 的准父母的项目数据。在 HBI 期间，经过培训的社区卫生工作者提供教育和咨询课程，并为参加有奖励的、教会组织的婴儿送礼会的孕妇及其男性伴侣提供免费的现场综合 HIV、乙型肝炎病毒和镰状细胞基因型检测。每位参与者都完成了一份由访谈者管理的问卷，内容包括人口统计学、生活方式习惯和 HIV 检测史。卡方检验用于比较 HIV 阳性和 HIV 阴性男性伴侣的特征。简单和多变量逻辑回归模型用于确定参与者特征与 HIV 阳性孕妇的男性伴侣 HIV 阳性之间的关联。
男性伴侣参与率为 57%（5264/9231）。总体 HIV 流行率为 6.1%（891/14495），女性（7.4%，681/9231）明显高于男性（4.0%，210/5264）。在 681 名 HIV 阳性女性中，有 289 名男性伴侣接受了 HIV 检测；37.7%（109/289）检测结果呈阳性。在多变量分析中，年龄较大（调整后的优势比[OR]：2.45，95%置信区间[CI]：1.27-4.72，年龄 30-39 岁 vs. <30 岁；OR：2.39，CI：1.18-4.82，年龄≥40 岁 vs. <30 岁）和自我报告的每日饮酒量（与从不饮酒（OR：0.35，CI：0.13-0.96））与 HIV 阳性孕妇的男性伴侣 HIV 阳性相关。
基于社区的会众方法是一种增加男性伴侣 HIV 检测的潜在策略，以实现联合国艾滋病规划署 90%HIV 筛查的目标。针对 HIV 阳性女性的男性伴侣进行筛查可能会提高 HIV 诊断的效果，并为该人群中的已知阳性患者提供参与治疗的机会。
