Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Center for Global Health, University of Colorado School of Public Health, Aurora, CO, USA.
Int J Gynaecol Obstet. 2021 Mar;152(3):409-415. doi: 10.1002/ijgo.13442. Epub 2020 Dec 10.
To examine the relationship between male partner involvement (MPI) in prevention of mother-to-child transmission (PMTCT) activities and successful completion of the PMTCT continuum of care, which remains sub-optimal in settings with high prevalence of HIV.
A cross-sectional survey was administered in June-August 2017 to a sample of 200 postpartum Kenyan women with HIV enrolled in a parent trial. Composite PMTCT and MPI variables were created. Descriptive, simple and multivariable regression, and mediation analyses were performed.
Of the women, 54% reported successful completion of PMTCT. Depression and internalized HIV stigma were independently associated with lower likelihood of successful completion of PMTCT (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI] 0.94-0.99; aRR 0.92; 95% CI 0.88-0.98, respectively). Each MPI activity was associated with 10% greater likelihood of successful completion of PMTCT (P < 0.05). The relationship between MPI and the successful completion of PMTCT was partially mediated through women's reduced internalized HIV stigma (β -0.03; 95%CI -0.06 to -0.00).
Greater MPI in PMTCT activities has direct and indirect effects on women's successful completion of all necessary steps across the PMTCT continuum. Reduced internalized HIV stigma is likely a key mechanism in the relationship.
探讨男性在预防母婴传播(PMTCT)活动中的参与度(MPI)与 PMTCT 照护连续体的完成情况之间的关系,在 HIV 流行率较高的环境中,后者仍不尽人意。
2017 年 6 月至 8 月,对参加一项父母试验的 200 名肯尼亚产后 HIV 感染妇女进行了横断面调查。创建了复合 PMTCT 和 MPI 变量。进行了描述性、简单和多变量回归以及中介分析。
在这些女性中,54%报告成功完成了 PMTCT。抑郁和内化的 HIV 耻辱感与成功完成 PMTCT 的可能性较低独立相关(调整后的风险比 [aRR] 0.97;95%置信区间 [CI] 0.94-0.99;aRR 0.92;95%CI 0.88-0.98)。每一项 MPI 活动都与成功完成 PMTCT 的可能性增加 10%相关(P<0.05)。MPI 与成功完成 PMTCT 之间的关系部分通过女性内化的 HIV 耻辱感降低而产生中介作用(β -0.03;95%CI -0.06 至 -0.00)。
MPI 在 PMTCT 活动中的增加对妇女成功完成 PMTCT 连续体上的所有必要步骤具有直接和间接的影响。内化的 HIV 耻辱感降低可能是两者关系的关键机制。