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Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique

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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.

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Acknowledgments

We wish to thank the following Friends in Global Health staff for their support during the implementation of the study: Monica Negrete, Wilson Silva, Jose Salato, Thomas Bonnet, and Idalina Passo. Above all, we recognize the Male Champions, traditional birth attendants, and study participants for their dedication and commitment to improving health care services in rural Mozambique.

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Authors and Affiliations

  1. Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN, 37203-1738, USA

    Carolyn M. Audet, Meridith Blevins, Muktar H. Aliyu, Lara M. E. Vaz, C. William Wester & Sten H. Vermund

  2. Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA

    Carolyn M. Audet & Muktar H. Aliyu

  3. Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA

    Meridith Blevins

  4. Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA

    C. William Wester & Sten H. Vermund

  5. Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA

    Sten H. Vermund

  6. Friends in Global Health, Maputo, Mozambique

    Yazalde Manuel Chire, Elisio Antonio, Fernanda Alvim & Ruth Bechtel

  7. Friends in Global Health, Quelimane, Mozambique

    Yazalde Manuel Chire, Elisio Antonio, Fernanda Alvim & Ruth Bechtel

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  1. Carolyn M. Audet
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  2. Meridith Blevins
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  3. Yazalde Manuel Chire
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  4. Muktar H. Aliyu
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  5. Lara M. E. Vaz
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  8. Ruth Bechtel
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  9. C. William Wester
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  10. Sten H. Vermund
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Correspondence to Carolyn M. Audet.

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Audet, C.M., Blevins, M., Chire, Y.M. et al. Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique. AIDS Behav 20, 2090–2100 (2016). https://doi.org/10.1007/s10461-016-1341-x

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