1. 1 Male involvement in PMTCT through invitation letters: The experience of Olievenhoutbosch Clinic in Tshwane District, South Africa VIKA N 1 ;Ntsimane S 1, Chima I 1, Mpofu D 1 1 Elizabeth Glaser Pediatric AIDS Foundation, South Africa December 6, 2011

2. Issues  Men often play a decisive role in family matters, including those related to the health and well-being of the family.  Male involvement and couples counselling and testing is critical for the success of prevention of mother-to-child transmission of HIV (PMTCT) programmes.  In South Africa, male involvement in reproductive health services, including PMTCT remains low, creating challenges and barriers around disclosure of HIV-positive status to a partner, psychosocial support, adherence to treatment, and infant feeding decisions.  In order to improve male involvement in PMTCT, Olivenhoutbosch Clinic, located in Tshwane District, Gauteng Province, and serving a population of 90,000, piloted the use of invitation letters to male partners of women attending antenatal care (ANC).

3. Description  The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) sensitized members of the Olievenhoutbosch Health Forum, which consists of 10 community based organisations (CBOs), and clinic staff about the importance of male involvement in PMTCT  Letters were used to invite men into the clinic to accompany partners.  In February 2010, nurses issued letters to the partners of all pregnant women visiting ANC.  On arrival at the clinic, all women accompanied by their male partners were counselled first by a nurse or a counsellor and given health education on PMTCT, infant feeding, dual protection, HIV counselling, testing and treatment issues.  Male partners were tested for HIV by a nurse and referred for treatment when HIV-positive.

4.  900 HIV-positive pregnant women were given invitation letters between February and December 2010.  356 (40%) of these women returned with their male partners and received health education on HIV/AIDS, PMTCT, and HIV counselling and testing.  During the time period the invitation letters were used, an increase in the total number of men receiving HIV counselling and testing was observed, from 1,002 in October-December 2009 to 1,340 in October-December, 2010 (see Figure 2).  32 male partners who were on ART joined a local support group run by Kings Hope, a community-based organization.  The data collected at the ANC indicated an increase in male involvement in PMTCT Results

5. 5 Figure 1. Proportion of women who came for testing and counseling with their male partners after receiving an invitation slip at Olievenhoutbosch Clinic

6. 6 Figure 2. Uptake of male HIV testing at Olievenhoutbosch Clinic (2009-2010)

7.  Men may be more likely to participate in PMTCT when invited to engage at an early stage of antenatal care.  Invitations to male partners in ANC can encourage men to receive HIV testing and treatment, and can also promote reproductive and family health.  EGPAF will assist in extending the male partner invitation model to other clinics in Tshwane, based on the observed success at Olievenhoutbosch Clinic. Conclusion