Strengthening male involvement in the prevention of mother-to-child transmission of HIV in Enugu State, Nigeria

This brief explores ways in which male involvement in the prevention of mother-to-child transmission of HIV (PMTCT) could be strengthened in Nigeria.

PMTCT services offered to women in Nigeria include: ante-natal care, basic information about HIV transmission and prevention; HIV counselling and testing; prevention of unintended pregnancy; and antiretroviral treatment. A lack of male involvement is considered a key challenge to the uptake of PMTCT.

The level and extent of male participation in PMTCT are influenced by individual and relationship factors, gendered norms and expectations, and health system factors.

Individual and relationship factors, included: time constraints, poor spousal communication, and non-disclosure of
status to one’s partner.

Gendered community norms and expectations included: pregnancy being perceived as a woman’s responsibility, male dominance in household decision making, and ridiculing of men who accompany women to ANC visits. Women do not discuss their visits with their male partners for fear of the repercussions of disclosure; non-disclosure of HIV status to male partners hinders male participation in PMTCT.

Maternal and child health services, on the whole, are not designed with men in mind, and men often do not feel welcome or needed in PMTCT. ANC is woman focused, there is an unwelcoming attitude of health workers to men who accompany their partners.

Perceived benefits of male partner participation in PMTCT included:

Male partners understanding and accepting the programme
Women being more free to access the programme
Reduction of the effects of male dominance on access to and uptake of PMTCT
Male partners being better positioned to support their female partners emotionally and financially
Couples being more able to work together towards preventing unintended pregnancies, and the promotion of adherence to treatment

By Nkoli Ezumah, Chinyere Mbachu,Obinna Onwujekwe, Ifeanyi Chikezie, Ogo Ibe, Patricia Uju Agbawodikeizu and Kingsley Amadi

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