Male participation and prevention of human immunodeficiency virus (HIV) mother-to-child transmission in Africa

The purpose of this review is twofold. First, it aims to summarize how the topic of male participation in HIV programs has been studied from a methodological point of view. The context is particularly in prevention of HIV transmission from mother to child (Prevention of Mother-to-Child Transmission, PMTCT). Second, it aims to describe how male participation has been described in the studies which have researched pregnant women's utilization of PMTCT programs, willingness and acceptance of testing for HIV and disclosure of HIV status to the male partner. This narrative review includes 31 studies (29 full texts and two abstracts) covering 15 different sub-Saharan African countries. The review showed that the approaches have been both qualitative and quantitative; varied study designs have been used in the varied settings. Male participation has been described to be both supportive and non-supportive. Supportive male participation such as a partner's willingness to be tested for HIV and spousal communication about reproductive matters has increased pregnant women's commitment to PMTCT programs. Non-supportive descriptions of male participation have included lack of discussion, HIV-related intimacy violence, and abandonment or fear of abandonment. Male participation has mostly been supportive of HIV positive mothers, but one challenge is how to prevent mother-to-child transmission in the case of non-supportive male participation. Another challenge is how to maintain the HIV negative status of pregnant women because few men have accepted testing. The development of the concept "male participation" in PMTCT of HIV programs might help to choose the most useful approaches to study it.