title: Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique.
abstract: Uptake of HIV testing and antiretroviral therapy (ART) services during antenatal care (ANC) in rural Mozambique is disappointing. To nurture supportive male engagement in ANC services, we partnered with traditional birth attendants and trained a new type of male-to-male community health agent, "Male Champions", who focused on counseling male partners to create new, male-friendly community norms around engagement in spousal/partner pregnancies. We assessed ANC service uptake using a pre-post intervention design. The intervention was associated with increases in: (1) uptake of provider-initiated counseling and testing among pregnant woman (81 vs. 92 %; p < 0.001); (2) male engagement in ANC (5 vs. 34 %; p < 0.001); and (3) uptake of ART (8 vs. 19 %; p < 0.001). When men accepted HIV testing, rates of testing rose markedly among pregnant women. With the challenges in scale-up of Option B+ in sub-Saharan Africa, similar interventions may increase testing and treatment acceptability during pregnancy.
authors.affiliation: Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA. carolyn.m.audet@vanderbilt.edu.|Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA. carolyn.m.audet@vanderbilt.edu.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Audet
authors.affiliation: Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA.|Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Meridith
authors.initials: M
authors.lastname: Blevins
authors.affiliation: Friends in Global Health, Maputo, Mozambique.|Friends in Global Health, Quelimane, Mozambique.
authors.forename: Yazalde Manuel
authors.initials: YM
authors.lastname: Chire
authors.affiliation: Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA.|Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Muktar H
authors.initials: MH
authors.lastname: Aliyu
authors.affiliation: Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA.
authors.forename: Lara M E
authors.initials: LM
authors.lastname: Vaz
authors.affiliation: Friends in Global Health, Maputo, Mozambique.|Friends in Global Health, Quelimane, Mozambique.
authors.forename: Elisio
authors.initials: E
authors.lastname: Antonio
authors.affiliation: Friends in Global Health, Maputo, Mozambique.|Friends in Global Health, Quelimane, Mozambique.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Alvim
authors.affiliation: Friends in Global Health, Maputo, Mozambique.|Friends in Global Health, Quelimane, Mozambique.
authors.forename: Ruth
authors.initials: R
authors.lastname: Bechtel
authors.affiliation: Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA.|Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: C William
authors.initials: CW
authors.lastname: Wester
authors.affiliation: Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA.|Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.|Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
mesh_terms: D003150:Community Health Workers; D055812:Community-Based Participatory Research; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008880:Midwifery; D009073:Mozambique; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D037841:Pregnant People / Q000208:ethnology / Q000523:psychology*; D011295:Prenatal Care; D012747:Sexual Partners; D016896:Treatment Outcome
keywords: Antenatal care; Community health workers; Male health care engagement; Mozambique; Prevention of mother to child HIV transmission