Department of Nursing, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
Infectious Diseases Institute, Makerere University, Kampala, Uganda.
BMC Health Serv Res. 2019 Aug 9;19(1):557. doi: 10.1186/s12913-019-4401-x.
Male partner involvement has been shown to increase mothers' uptake of Prevention of Mother-to-Child Transmission of HIV (PMTCT) and improve maternal and infant HIV treatment outcomes. Currently, male involvement in PMTCT is measured primarily through men's attendance at HIV testing and counselling which may not be a true reflection of their engagement. This study therefore set out to explore the meaning of male partner involvement and propose a definition and theoretical model of this concept in PMTCT in Uganda.
Eight focus group discussions and five in-depth interviews were conducted with couples at three public health facilities and community members in the health facility catchment areas in Uganda. The study employed a grounded theory approach underpinned by the pragmatic philosophical paradigm. Data were analyzed using the constant comparative method, performing three levels of open, axial, and selective coding.
Of the 61 participants, 29 (48%) were male and the majority 39 (63.9%) were in long term marital relationships, while about half were self-employed 29 (47.5%). Three themes emerged for the meaning of male involvement in PMTCT (a) HIV treatment support (b) economic support and (c) psychosocial support. HIV treatment support included adherence support, couples' HIV counseling and testing, and clinic attendance during and after pregnancy. Participants expressed that men were engaged in PMTCT when they offered economic support by providing basic needs and finances or when they included their female partners in financial planning for the family. Psychosocial support arose from the female participants who defined male involvement as family support, perceived societal recognition and emotional support. Emotional support also included the absence of harm resulting from women's disclosure of HIV test results to their male partner.
This study proposes a new definition for male partner involvement in PMTCT in Uganda. The definition extends beyond men's clinic attendance and HIV testing and counselling. Further research should seek to develop and validate tools to accurately measure male partner involvement as the next step in the development of interventions to improve PMTCT outcomes.
已证实男性伴侣的参与可增加母亲对预防艾滋病毒母婴传播（PMTCT）的接受程度，并改善母婴艾滋病毒治疗结局。目前，PMTCT 中男性参与度主要通过男性接受艾滋病毒检测和咨询来衡量，但这可能并不能真实反映他们的参与度。因此，本研究旨在探讨男性伴侣参与的意义，并提出乌干达 PMTCT 中这一概念的定义和理论模型。
在乌干达的三个公立卫生机构和卫生机构服务范围内的社区中，对 61 对夫妇进行了 8 次焦点小组讨论和 5 次深入访谈。该研究采用扎根理论方法，并以实用主义哲学范式为基础。使用不断比较法对数据进行分析，进行了三级开放式、轴向和选择性编码。
在 61 名参与者中，29 名（48%）为男性，大多数（63.9%）处于长期婚姻关系中，约有一半为个体经营者（47.5%）。在 PMTCT 中，男性参与的意义出现了三个主题（a）艾滋病毒治疗支持、（b）经济支持和（c）心理社会支持。艾滋病毒治疗支持包括坚持治疗支持、夫妇艾滋病毒咨询和检测，以及在怀孕期间和怀孕后到诊所就诊。参与者表示，当男性提供基本需求和资金的经济支持或让其女性伴侣参与家庭财务规划时，他们就参与了 PMTCT。心理社会支持来自于女性参与者，她们将男性参与定义为家庭支持、社会认可和情感支持。情感支持还包括女性向其男性伴侣透露艾滋病毒检测结果时，男性伴侣没有伤害她。
本研究提出了乌干达 PMTCT 中男性伴侣参与的新定义。该定义超出了男性到诊所就诊和接受艾滋病毒检测和咨询的范围。进一步的研究应该寻求开发和验证工具，以准确衡量男性伴侣的参与度，作为提高 PMTCT 结局的干预措施发展的下一步。
