CHAPTER ONE

INTRODUCTION

1.1            Background of the study

Generally, research has highlighted the beneficial impact of male involvement in programmes to prevent the mother-to-child transmission of HIV to tackle new infections among infants. A 2015 study of couples in South-West province, Nigeria looked at the factors associated with male involvement in PMTCT (Kalembo, 2013).  It found men from couples who had previously experienced HIV testing and counselling (HTC) were more likely to be involved in PMTCT. This implies that promoting HTC in all other HTC entry points might enhance male involvement in PMTCT. Having time to visit the clinic with his partner also meant a man was more likely to be involved in PMTCT (Makoni, 2015).

Health workers’ friendliness towards male partners was significantly associated with male involvement in PMTCT. The study found that those men who were made to feel needed and an important part of the pregnancy by health workers when they accompanied their wives for ANC were more likely to become involved in PMTCT (Kalua, 2017).  Being afraid of knowing one’s HIV status was associated with male partners being less likely to be involved in PMTCT. About 45 % of the male partners interviewed in the study reported that they engaged in extra marital affairs. The majority of these men refused to accompany their wives for PMTCT due to the fear of knowing their HIV status, which might result in stigma, discrimination, domestic violence or abandonment by their wife if positive. Three quarters of respondents also highlighted how fear of HIV test results was the main barrier to male involvement in PMTCT. Men who perceived themselves at risk of HIV were therefore more likely to refuse to go for couple HTC. This implies the need for more HIV educational and behaviour change communication programmes for male partners in order to address issues to do with the benefits of knowing one’s HIV status (Makoni, 2015). Inviting men to use voluntary HTC services, offering PMTCT services at sites other than ANC ones (such as bars, churches and workplaces), as well as prior knowledge  of HIV and HIV testing facilities have all been identified as ways of increasing male involvement (Morfaw, 2013).

1.2       Statement of the problem

Every day there are nearly 1800 new HIV infections in children under 15 years of age, more than 90% occurring in the developing world. Most (about 90%) of these infections are associated with mother-to-childtransmission (MTCT). Moreover about, 1400 children under 15 years of age die of an HIV-related illness per day. Poor male partner involvement in PMTCT services is one of the factors contributing to reduced effectiveness of the PMTCT and hence failure to achieve the elimination of maternal to child transmission of HIV. For this reason, this pertinent question formed the birth rock of this study:  what is the level of male partner involvement into PMTCT services