Consequences of male partner engagement policies on HIV care-seeking in three African countries: Findings from the SHAPE UTT study

Dube, A. et al. (2021) Consequences of male partner engagement policies on HIV care-seeking in three African countries: Findings from the SHAPE UTT study. Global Public Health, 16(2), pp. 216-226. (doi: 10.1080/17441692.2020.1805788) (PMID:32780669)

Abstract

We explored how strategies to promote male partner engagement influenced HIV care-seeking among men and women living with HIV. In-depth interviews were conducted with 25 health workers, 66 female service users and 10 male partners in Ifakara (Tanzania), Karonga (Malawi) and uMkhanyakude (South Africa) to elicit experiences of offering, providing or receiving HIV care in the context of antenatal care. Data were coded inductively and analysed thematically. Participants reported benefits of couple testing during antenatal care, including facilitated HIV status disclosure and mutual support for HIV care-seeking. However, unintended consequences included women attending without partners, being refused or delayed access to antenatal services. Some women were required to obtain letters from village leaders to justify the absence of their partners, again to delaying or disrupting care-seeking. When partners attended antenatal care, consultations were reportedly more likely to focus on HIV testing, and less on antenatal or neonatal care. Strategies to increase men’s attendance at HIV clinics with their partners can promote mutual support within couples for HIV care engagement, but may risk undermining engagement in pregnancy and HIV care for some women if over-stringently applied. Efforts are needed to address the underlying pervasive stigma associated with HIV care, both alone and as a couple.

• Item Type: Articles
• Additional Information: This work was supported by the Medical Research Council, United Kingdom through a Health Systems Research Initiative grant [grant number MR/ P014313/1]. JR receives funding support from DELTA/THRIVE (DELTA/ THRIVE-2) under [grant number DEL15-011/07742/Z/15/Z].
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Dube, A., Renju, J., Wamoyi, J., Hassan, F., Seeley, J., Chimukuche, R. S., Songo, J., Kalua, T., Crampin, A., Moshabela, M., and Wringe, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Global Public Health
• Publisher: Taylor & Francis
• ISSN: 1744-1692
• ISSN (Online): 1744-1706
• Published Online: 11 August 2020
• Copyright Holders: Copyright © 2020 The Author(s).
• First Published: First published in Global Public Health 16(2):216-226
• Publisher Policy: Reproduced under a Creative Commons Licence