Invitation cards during pregnancy enhance male partner involvement in prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) in Blantyre, Malawi: a randomized controlled open label trial.
BACKGROUND
Male involvement (MI) is vital for the uptake of Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) interventions. Partner notification (PN) is among the strategies identified for MI in PMTCT services. The purpose of this randomized controlled trial was to evaluate the efficacy of an invitation card to the male partners as a strategy for MI in PMTCT services by comparing the proportion of pregnant women that were accompanied by their partners between the intervention and the non-intervention study groups.


METHODS
Pregnant women attending antenatal care without a male partner at South Lunzu and Mpemba health centres in Blantyre, Malawi, were enrolled in the study from June to December 2013. In an intention-to-treat analysis, we compared all participants that were randomized in the invitation card group with the standard of care (SoC) group. Risk ratios (RR) with 95% confidence intervals (CI) were computed to assess the efficacy of the invitation card.


RESULTS
Of the 462 randomized women, 65/230 (28.26%) of the women in the invitation card group reported to the antenatal care clinic with their partners compared to 44/232 (18.97%) women in the SoC group. In an unadjusted intention-to-treat analysis women in the invitation card group were 50% more likely to be accompanied by their male partners than those in the SoC group RR: 1.49 (95% CI: 1.06-2.09); p = 0.02. Our random effects analysis showed that there was no clustering by site of recruitment with an inter cluster correlation coefficient (ICC) of 1.98 x 10(-3), (95% CI: 1.78 x10(-7) - 0.96 x 10(-1)); p =0.403.


CONCLUSIONS
An invitation card significantly increased the proportion of women who were accompanied by their male partners for the PMTCT services. An invitation card is a feasible strategy for MI in PMTCT.
School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Alinane Linda
AL
Nyondo
Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Augustine Talumba
AT
Choko
Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi.
Angela Faith
AF
Chimwaza
School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Adamson Sinjani
AS
Muula
D000328:Adult; D005260:Female; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D008297:Male; D009035:Mothers / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012747:Sexual Partners / Q000523:psychology; D018454:Spouses / Q000523:psychology