Karen Hampanda1,2, Anna Helova3, Tobias Odwar4, Thomas Odeny4,5, Maricianah Onono4, Elizabeth Bukusi4, Janet Turan3, Lisa Abuogi2,6. 1. Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 2. Center for Global Health, University of Colorado School of Public Health, Aurora, CO, USA. 3. Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. 4. Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya. 5. Department of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA. 6. Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Keywords:
Breastfeeding; Couples; Male partner involvement; Maternal and child health; Pregnancy; Prevention of mother-to-child transmission; Sub-Saharan Africa; Vertical HIV
Authors: Brandon A Knettel; Cody Cichowitz; James Samwel Ngocho; Elizabeth T Knippler; Lilian N Chumba; Blandina T Mmbaga; Melissa H Watt Journal: J Acquir Immune Defic Syndr Date: 2018-04-15 Impact factor: 3.731
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