Naddunga Faith, Bulterys Michelle A, Nakyanzi Agnes, Donnell Deborah, Kyomugisha Juliet, Birungi Juliet E, Ssendiwala Paul, Nsubuga Rogers, Muwonge Timothy R, Musinguzi Joshua, Peacock Sue, Celum Connie L, Mujugira Andrew, Sharma Monisha
Infectious Diseases Institute, Makerere University, Kampala, Uganda.
Department of Global Health, University of Washington, Seattle, Washington, USA.
J Int AIDS Soc. 2025 Apr;28(4):e26440. doi: 10.1002/jia2.26440.
Male partner HIV testing and engagement in antenatal care (ANC) is associated with improved clinical outcomes for men, pregnant women and infants. However, testing rates remain low among male partners of pregnant women receiving ANC in Africa. We evaluated the impact of male peer outreach to increase HIV testing among partners of pregnant women in Uganda.
We conducted a randomized trial in Kampala, Uganda, enrolling an equal number of pregnant women with and without HIV from public ANC clinics who were randomized 1:1 to intervention or standard-of-care (SOC) with delayed intervention after 1 month. (ClinicalTrials.gov ID, NCT05388084). The intervention consisted of male peer counsellors calling male partners of consenting pregnant women and inviting them to test for HIV. In the SOC, pregnant women received an invitation letter to deliver to their partners for fast-track HIV testing, per national guidelines. We conducted an intention-to-treat analysis using modified Poisson regression, comparing the proportion of male partners tested for HIV by month 1 across arms overall and by female's HIV status. A secondary analysis compared the proportion tested for HIV by 3 months after both arms received the intervention.
Between May 2022 and March 2023, we enrolled 150 pregnant women (76 in intervention, 74 in SOC). At 1 month, 18% more males in the intervention arm tested for HIV compared to SOC (32% vs. 14%; risk difference [RD] = 0.18; 95% confidence interval [CI]: 0.05-0.31). This association remained significant after stratifying by female HIV status. HIV testing was 22% higher among male partners of HIV-negative women in the intervention arm compared to SOC (46% vs. 24%; RD = 0.22; 95% CI: 0.004-0.430) and 15% higher among partners of pregnant women with HIV (18% vs. 3%; RD = 0.15; 95% CI: 0.02-0.28). At 3 months, 50% (38/76) of male partners tested in the intervention versus 35% (26/74) in the SOC/delayed intervention (RD = 0.15; 95% CI: -0.01 to 0.31).
Male peer outreach is a promising intervention to increase knowledge of HIV status among partners of pregnant women. Additional support is needed to increase HIV testing among partners of women with HIV.
男性伴侣进行HIV检测并参与产前护理（ANC）与男性、孕妇和婴儿更好的临床结局相关。然而，在非洲接受ANC的孕妇的男性伴侣中，检测率仍然很低。我们评估了男性同伴外展服务对提高乌干达孕妇伴侣中HIV检测率的影响。
我们在乌干达坎帕拉进行了一项随机试验，从公共ANC诊所招募了数量相等的感染HIV和未感染HIV的孕妇，她们被1:1随机分配到干预组或标准护理（SOC）组，1个月后对SOC组进行延迟干预。（ClinicalTrials.gov标识符，NCT05388084）。干预措施包括男性同伴咨询师致电同意参与的孕妇的男性伴侣，并邀请他们进行HIV检测。在SOC组中，孕妇按照国家指南收到一封邀请函，由她们转交给伴侣以进行快速HIV检测。我们使用修正的泊松回归进行意向性分析，比较总体上各臂在第1个月时进行HIV检测的男性伴侣比例以及按女性HIV感染状况分层后的比例。一项次要分析比较了两组接受干预后3个月时进行HIV检测的比例。
在2022年5月至2023年3月期间，我们招募了150名孕妇（干预组76名，SOC组74名）。在第1个月时，干预组进行HIV检测的男性比SOC组多18%（32%对14%；风险差异[RD]=0.18；95%置信区间[CI]：0.05 - 0.31）。按女性HIV感染状况分层后，这种关联仍然显著。干预组中HIV阴性女性的男性伴侣进行HIV检测的比例比SOC组高22%（46%对24%；RD = 0.22；95% CI：0.004 - 0.430），HIV感染孕妇的伴侣中这一比例高15%（18%对3%；RD = 0.15；95% CI：0.02 - 0.28）。在3个月时，干预组中有50%（38/76）的男性伴侣进行了检测，而SOC/延迟干预组为35%（26/74）（RD = 0.15；95% CI： - 0.01至0.31）。
男性同伴外展服务是一种有前景的干预措施，可提高孕妇伴侣对HIV感染状况的知晓率。需要额外的支持来提高HIV感染女性伴侣中的HIV检测率。
