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During pregnancy, offering HIV testing at home doubles the proportion of male partners who test
Roger Pebody, 2016-02-24 10:40:00
A programme of home visits, partner education and HIV
testing for couples in Kenya was able to double the proportion of men who
tested during their partner’s pregnancy, Carey Farquhar of the University of
Washington told the Conference
on Retroviruses and Opportunistic Infections (CROI 2016) in Boston yesterday.
Partners became aware of each other’s HIV status without this being linked to
an increase in intimate partner violence.
Whereas HIV testing is widely offered to women attending
antenatal clinics, there are fewer opportunities for men to test. In African
countries, no more than a third of men take an HIV test during their female
partner’s pregnancy, but there are particular advantages to engaging with men
at this time.
The male partner may strongly influence decisions affecting
women’s reproductive health. Pregnant women who are
diagnosed with HIV during individual HIV counselling and testing, without the
support of their partner, may be afraid of disclosing their HIV status to him.
Moreover they are less likely to adhere to HIV treatment during pregnancy and
other interventions to prevent mother-to-child transmission.
In the case of a couple where the man has HIV and the woman
does not, lack of male partner HIV testing may result in the woman
seroconverting to HIV during pregnancy or breastfeeding (a period of elevated transmission risk). A woman who has herself just become HIV positive would have a very high
viral load, putting her at exceptionally high risk of passing the infection on
to her child.
Several interventions have been shown to modestly improve
HIV testing rates in male partners, but have not had the large effect seen in
the study presented yesterday. These interventions have included letters to
invite male partners to attend HIV testing at antenatal clinics, making
antenatal clinics more ‘male friendly’ and adapting post-test counselling for
women so that it develops their communication skills and self-efficacy.