A Novel Intervention to Increase Male Involvement in Prevention of Parent to Child HIV Transmission

Abstract

Background: Prevention of Parent To Child Transmission (PPTCT) of HIV is a major intervention to stop the spread of HIV. Rates of <2% are possible with early combination antiretroviral therapy. Tearfund African PPTCT Alliance (TAPA) supports a network of African partners in PPTCT through a church-based community outreach. To promote quality, TAPA conducts periodic programme audits to strengthen male partner involvement in PPTCT. Methods: The present audit was conducted among 11 TAPA partners in August 2011 to determine factors responsible for poor Prevention of Mother To Child Transmission (PMTCT) of HIV or PPTCT uptake in areas where churches and faith-based organizations work. Participants were all expectant mothers, male sexual partners and infants registered at these clinics. Each record was evaluated for evidence of HIV testing, results, treatment and prophylaxis against mother to child HIV transmission. Information on infant feeding patterns were also gathered. Intervention: In 2009, TAPA partners identified the need for a training toolkit to stimulate greater male partner involvement in PPTCT through antenatal clinics (ANCs) in church-based sites. The toolkit entitled “Guardians of our Children Health (GOOCH)” identified men as guardians of the health of their families and was designed to build the knowledge and skills of both parents to reduce HIV transmission to their infant. GOOCH has been successfully piloted by two organizations in Jos, Nigeria since 2008—Faith Alive Foundation (FAF) and ECWA AIDS Ministry (TEAM), as well as 14 other organizations across Africa. Lessons Learned: Male involvement in PPTCT through GOOCH increases rates of HIV testing among pregnant women (sometimes up to five times); motivates male partner involvement in PPTCT; and raises PPTCT awareness in communities. Records on men are not always kept at ANC clinics. Often there is a lack of follow up. National policies for ARV intervention are often inconsistent and change too quickly. Infant feeding patterns are mixed and not all programmes were able to obtain reliable data to assess this area of preventing transmission of HIV. Next Steps: Advocacy for improvements and scaling up of PPTCT especially with Nigeria being the lowest in Africa. Scale up GOOCH in communities where it was most effective and introduce it to communities where it is likely to have the greatest impact. Also, adopt the concept of Integrated Supportive Supervision trainings with integration of Maternal Child Health (MCH) into all levels of health care system.