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Improving male involvement in antenatal care in low and middle-income countries to prevent mother to child transmission of HIV: A realist review

Clark, J, Sweet, L, Nyoni, S and Ward, PR 2020, Improving male involvement in antenatal care in low and middle-income countries to prevent mother to child transmission of HIV: A realist review, PLoS ONE, vol. 15, no. 10, pp. 1-22, doi: 10.1371/journal.pone.0240087.

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Title Improving male involvement in antenatal care in low and middle-income countries to prevent mother to child transmission of HIV: A realist review
Author(s) Clark, J
Sweet, LORCID iD for Sweet, L orcid.org/0000-0003-0605-1186
Nyoni, S
Ward, PR
Journal name PLoS ONE
Volume number 15
Issue number 10
Start page 1
End page 22
Total pages 22
Publisher PLOS
Place of publication San Francisco, CA
Publication date 2020-10-15
ISSN 1932-6203
Keyword(s) Health education and awareness
Uganda
Virus testing
Database searching
HIV prevention
HIV
Pregnancy
Antenatal care
Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
PREGNANT-WOMEN
MALE PARTNERS
SERVICES
PARTICIPATION
PMTCT
BARRIERS
SUPPORT
TRIAL
KENYA
Summary Background: Childhood Human Immunodeficiency Virus (HIV) infection occurs almost exclusively via mother to child transmission (MTCT) during pregnancy, birth, or through breastfeeding. Recent studies have shown that male involvement (MI) in antenatal care (ANC) and HIV testing, including couples voluntary counselling and testing (CVCT), increases the likelihood that women will adhere to prevention advice and comply with HIV treatment if required during their pregnancy; hence reducing the rates of MTCT of HIV. This realist review investigates how, why, when, and for whom MI in ANC works best to provide contextual advice on how MI in ANC can be best used for prevention of mother to child transmission (PMTCT) of HIV. Methods: A realist review of existing evidence was conducted. Realist review seeks to explain how and why an intervention works, or does not work, in a given context. This was completed through the five stages of realist synthesis; Eliciting the program theory, search strategy, study selection criteria, data extraction, and data analysis and synthesis. Findings are presented as context-mechanism-outcome (CMO) configurations outlining the mechanisms that work in given contexts to give an outcome. Results: Three CMO configurations were developed. These describe that 1) Couples in monogamous relationships have higher levels of trust, commitment and security leading to increased uptake of PMTCT programs together; 2) ANC spaces that make ‘male friendly’ adaptions promote normalisation of MI in PMTCT and are more welcoming, leading to increased willingness of male partners to participate in ANC; and 3) couples and communities with higher health literacy encourage increased informed decision making, ownership, and responsibility and thus increased participation in PMTCT of HIV. Conclusions: The CMOs developed in this review give contextual advice on how one might improve ANC services to increase MI and help reduce MTCT of HIV. We propose that MI in ANC works best where couples are monogamous and trusting, where ANC spaces actively promote being a ‘male friendly space’ and where there are high levels of community education programs around MTCT.
Language eng
DOI 10.1371/journal.pone.0240087
Indigenous content off
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2020, Clark et al.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30144469

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.