This paper represents the first stage of a study aiming to identify interventions to improve male involvement along the cascade of HIV services in Malawi. Few programs have been implemented, but much improvement is still needed to enhance the male involvement, thus it is important to identify better strategies in PMTCT and in healthcare services in general. Male involvement has been recognized as a priority in PMTCT but currently remains a challenge in most low- and middle-income countries. showed that women with male support in PMTCT were 3.5 times more likely to have good adherence than those without support. in Zimbabwe and Malawi for instance shows that one of the main barriers to women initiating and adhering to ART were their male partners. Some studies have demonstrated that male support is relevant to women’s adherence to therapy in PMTCT. However, in some circumstances, men involvement could be considered disadvantageous to their partners since it may reinforce their role and promote men control over women’s decision. In this study male involvement in PMTCT was not limited to accompanying the woman to the clinic and perform Couple HIV Testing and Counselling (CHTC), but also supporting the woman during the treatment from an economic and psychosocial point of view. Several definitions have been used in previous studies, but the most comprehensive one was proposed by Muwanguzi et al. Male involvement is not a well-defined concept and currently there is no single widely used indicator to measure it. In many low-income countries, the involvement of men in maternal services is increasingly recognised as an important element of women’s access to needed care. Previous literature shows that in Sub-Saharan Africa (SSA), male partners are scarcely present during PMTCT services.
Women infected represent 59.8% of adults living with HIV. It is estimated that one million Malawians, adults and children, are infected with HIV. Malawi is one of the countries with higher HIV prevalence in the adult population (15–49 years) amounting to 9.2% in 2018. The WHO African Region was most severely affected with 25.7 million people HIV positive people. Worldwide, there were 1.3 million pregnant women living with HIV in 2018, among them the 82% received Antiretroviral Therapy (ART) for Prevention Mother-To-Child Transmission (PMTCT). Of these, 36.2 million were adults and 1.7 million were children (< 15 years old). In 2018, 37.9 million people across the globe were living with HIV/AIDS. Moreover, the study points out that gender power relationships and stringent gender norms play a crucial role thus they should be considered to enhance male involvement. This study highlights that women’s level of knowledge on HIV and their economic condition (employment and owning a means of transport) affects male attendance. Our study shows a high male attendance in Malawi compared to other studies performed in SSA. Level of attitude and practice toward HIV were not significantly associated to our study variable. In the multivariable model, women’s unemployment and owning a means of transport are negatively associated with male attendance (respectively adjusted OR 0.32 and 0.23 ), whereas, in the univariable model, high women’s level of knowledge of HIV is positively associated with male attendance (OR 2.17 ). We enrolled 128 HIV-positive women: 82 (64.1%) were accompanied by their male partners and 46 (35.9%) were alone. We applied descriptive statistics and logistic regressions to study the association between being accompanied and explanatory variables. Our primary objective was to assess and analyse the proportion of women who were accompanied by their partner at least once. We provided a KAP survey to women and their partners attending the facilities.
Eligible women were aged 18 years or older, living with a male partner, enrolled for the first time in one of the four selected facilities. We included pregnant women enrolled in PMTCT programme between August 2018 and November 2019 in the Southern Region of Malawi. This study aims to identify the socio-demographic characteristics, HIV-Knowledge, Attitude and Practice (KAP) among women accompanied and not accompanied by their male partners. Male involvement is increasingly recognised as an important element of women’s access to care. Male partners are rarely present during PMTCT (Prevention-Mother-To-Child-Transmission) services in Sub-Saharan Africa (SSA).
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