Midwives' perspectives on male participation in PMTCT of HIV and how they can support it in Lusaka, Zambia

Objective: the purpose of this study is to describe midwives' perspectives on (1) male participation in Prevention of Mother-To-Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) and (2) the methods that could be used to improve male participation in the Lusaka District, Zambia. Design: a qualitative descriptive study. Data were collected using 10 open-ended questions. Setting: 25 public antenatal clinics in the Lusaka District, Zambia. Participants: midwives (n=45). Findings: content analysis highlighted that a male partner can prevent his wife and his infant from being exposed to HIV by preventive behaviour in their intimate relationship and by utilising health-care services. Several barriers to male participation were identified. These were linked to the male partner himself, to health-care services and to society. Stigma as a multifaceted barrier was considered to permeate every level. The sources of the resources that a male partner needs to prevent Mother-To-Child Transmission (MTCT) were the male partner himself, health-care services and society. The methods that midwives can use to improve male participation were the following: first, influencing individuals, the community, employers and health personnel; second, intervening in risk behaviour; and third, providing disease intervention services. Key conclusion: male participation in PMTCT of HIV is diverse, not only in HIV testing at the beginning of pregnancy, and it is influenced by various dimensions. Midwives' methods to improve male participation were broad, extending outside the antenatal clinic. A shortage of midwives and other typical issues of limited resources of developing countries pose challenges to male participation in PMTCT of HIV. Implication for practice: the study showed that cultivating a male-friendly approach in antenatal care is urgent to protect infants.