Will Your Partner Be Attending? Involving men in the prevention of mother to child transmission of HIV in antenatal care clinics in Iringa, Tanzania Kikumbih N; Motta W; Nielsen-Bobbit J; Mbandi A; Killian R; Mwanga F; Barone M; and Perchal P EngenderHealth ACQUIRE Tanzania Project

Objective To explore the feasibility and impact of male involvement initiatives to increase male attendance and service utilization at PMTCT sites

Demographic Profile in Iringa Population size Total population = 1,737,382 (2010 projection) WRA = 441,315 HIV/AIDS National HIV prevalence rate is 5.7% Iringa HIV prevalence is 16% Pregnant women HIV prevalence is 5% Source: Tanzania DHS 2010; HIV survey 2008

Background EngenderHealth’s ACQUIRE Tanzania Project (ATP) supports the MOHSW to increase access to and use of quality family planning and PMTCT services More than 90% of women attending ANC are tested for HIV, yet most male partners are not informed of PMTCT services [UNAIDS, 2011] Males have been traditionally seen as “facilitators” of their partners to access RH services [WHO, 2012] Men accompanying their partners to ANC represents a key opportunity for engaging them in HIV and FP services

Why Male Involvement? Men make a lot of the decisions regarding reproductive health (e.g., condom use) [WHO, 2012] Male involvement can: –Reduce stigma and discrimination directed to HIV-positive women (e.g., fear of HIV disclosure) –Improve treatment adherence [Farquhar et al, 2004] –Improve couple communication regarding sexuality issues.

Male Involvement Interventions (2008 onwards) Training Infrastructure Posters Invitation to men Men invited to ANC health talks Male friendly health services provided at ANC Couples given first priority for PMTCT services

Evaluation Methodology Program data was collected monthly in all 351 sites providing PMTCT services between 2008 – 2011 Data collected included: –ANC attendance for women and men –HIV testing EPI-INFO used for analysis

Results: Increased Male Involvement

Male Partners’ HIV Testing Trend Partners tested 1,74610,59520,75822,623 Partners tested HIV (+) 2741,4322,5492,175 HIV prevalence 15.7%13.6%12.3%9.6%

Ongoing Challenges RH policies target women instead of couples Provider bias and negative attitude about men’s participation in ANC and labor/delivery Male involvement slow to pick-up despite interventions

Lessons Learnt Local male involvement initiatives can encourage men to accompany their partners at ANC Men are exposed to correct information on HIV and PMTCT through participation in health talks and couples counseling Male involvement initiatives have contributed to more men getting tested for HIV, and those positive were referred to care and treatment

ACKNOWLEDGEMENT PEPFAR MOHSW Districts – Council Health Management Teams (CHMTs) PMTCT sites staff Engender health Partners

Thank you