title: Male antenatal attendance and HIV testing are associated with decreased infant HIV infection and increased HIV-free survival.
abstract: OBJECTIVE
  To investigate the relationship between male involvement in prevention of mother-to-child HIV transmission services and infant HIV acquisition and mortality, a prospective cohort study was undertaken between 1999 and 2005 in Nairobi, Kenya.
  
  
  METHODS
  HIV-infected pregnant women were enrolled and followed with their infants for 1 year with infant HIV DNA testing at birth, 1, 3, 6, 9, and 12 months postpartum. Women were encouraged to invite male partners for prevention counseling and HIV testing.
  
  
  RESULTS
  Among 456 female participants, 140 partners (31%) attended the antenatal clinic. Eighty-two (19%) of 441 infants tested were HIV infected by 1 year of age. Adjusting for maternal viral load, vertical transmission risk was lower among women with partner attendance compared with those without [adjusted hazard ratio (aHR) = 0.56, 95% confidence interval (CI): 0.33 to 0.98; P = 0.042] and among women reporting versus not reporting previous partner HIV testing (aHR = 0.52, 95% CI: 0.32 to 0.84; P = 0.008). The combined risk of HIV acquisition or infant mortality was lower with male attendance (aHR = 0.55; 95% CI: 0.35 to 0.88; P = 0.012) and report of prior male HIV testing (aHR = 0.58; 95% CI: 0.34 to 0.88; P = 0.01) when adjusting for maternal viral load and breastfeeding.
  
  
  CONCLUSIONS
  Including men in antenatal prevention of mother-to-child HIV transmission services with HIV testing may improve infant health outcomes.
authors.affiliation: Stony Brook University Medical Center, Stony Brook, NY, USA. adam.aluisio@hsc.stonybrook.edu
authors.forename: Adam
authors.initials: A
authors.lastname: Aluisio
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: Rose
authors.initials: R
authors.lastname: Bosire
authors.forename: Grace
authors.initials: G
authors.lastname: John-Stewart
authors.forename: Dorothy
authors.initials: D
authors.lastname: Mbori-Ngacha
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003376:Counseling; D005220:Fathers / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D007630:Kenya / Q000453:epidemiology; D008297:Male; D009934:Organization and Administration; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D019380:Anti-HIV Agents