Official invitation letters to promote male partner attendance and couple voluntary HIV counselling and testing in antenatal care: an implementation study in Mbeya Region, Tanzania.
Official invitation letters to promote male partner attendance and couple voluntary HIV counselling and testing in antenatal care: an implementation study in Mbeya Region, Tanzania.
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DOI：
10.1186/s12978-015-0084-x
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发表时间：
2015-10-15
影响因子：
3.4
通讯作者：
Theuring S
中科院分区：
文献类型：
--
作者：
Jefferys LF;Nchimbi P;Mbezi P;Sewangi J;Theuring S
男性伴侣参与产前护理和预防艾滋病毒母婴传播对孕产妇和婴儿健康结果的好处已得到充分认识。然而，在撒哈拉以南非洲的许多环境中，男性参与这些服务的程度仍然很低。之前的研究表明，书面邀请函是促进男性伴侣参与的一种方式。在坦桑尼亚西南部的三个研究地点进行的这项实施研究中，评估了男性伴侣书面邀请函的可接受性。在研究地点记录的研究前CVCT率为2 - 19%。在没有男性伴侣的情况下接近ANC的孕妇收到一封正式信件，邀请其伴侣参加ANC和夫妇自愿咨询和测试（CVCT）联合会议。在随后的产前检查中记录伴侣的出席情况，如果伴侣没有出席，则重复邀请。还分析了与男性伴侣出席非国大有关的社会人口指数。318名妇女收到了其伴侣的邀请函，其中53.5%的妇女同其伴侣一起返回参加非洲人国民大会联合会议；其中81%进行了cct。自我报告的基线hiv阳性状态与伴侣回归呈负相关（p = 0.033）。男性出勤率在农村和城市研究地点之间差异显著（p < 0.001），农村地点的出勤率高达76%，而城市卫生中心的出勤率为31%。大多数妇女认为非洲人国民大会联席会议是一次有利的经历，然而，艾滋病毒阳性的不和谐或和谐关系中的7名妇女（75%）报告在相互披露时出现了问题。会议结束一个月后报告的有益结果包括改善了客户-提供者关系，改善了夫妻之间的沟通，加强了性健康和生殖健康决策。在撒哈拉以南非洲资源有限的情况下，官方邀请函是一种可行的干预措施，受到夫妇成员的高度接受，是鼓励男性参加非国大和CVCT的有效途径。所有地点的干预前CVCT率均有所提高。然而，与规模较小的农村保健中心相比，城市环境可能需要额外强调达到较高的伴侣出勤率。
The benefits of male partner involvement in antenatal care (ANC) and prevention of mother-to-child transmission of HIV (PMTCT) for maternal and infant health outcomes have been well recognised. However, in many sub-Saharan African settings, male involvement in these services remains low. Previous research has suggested written invitation letters as a way to promote male partner involvement. In this implementation study conducted at three study sites in southwest Tanzania, acceptability of written invitation letters for male partners was assessed. Pre-study CVCT rates of 2–19 % had been recorded at the study sites. Pregnant women approaching ANC without a male partner were given an official letter, inviting the partner to attend a joint ANC and couple voluntary counselling and testing (CVCT) session. Partner attendance was recorded at subsequent antenatal visits, and the invitation was repeated if the partner did not attend. Analysis of socio-demographic indices associated with male partner attendance at ANC was also performed. Out of 318 women who received an invitation letter for their partner, 53.5 % returned with their partners for a joint ANC session; of these, 81 % proceeded to CVCT. Self-reported HIV-positive status at baseline was negatively associated with partner return (p = 0.033). Male attendance varied significantly between the rural and urban study sites (p < 0.001) with rates as high as 76 % at the rural site compared to 31 % at the urban health centre. The majority of women assessed the joint ANC session as a favourable experience, however 7 (75 %) of women in HIV-positive discordant or concordant relationships reported problems during mutual disclosure. Beneficial outcomes reported one month after the session included improved client- provider relationship, improved intra-couple communication and enhanced sexual and reproductive health decision-making. Official invitation letters are a feasible intervention in a resource limited sub-Saharan African context, they are highly accepted by couple members, and are an effective way to encourage men to attend ANC and CVCT. Pre-intervention CVCT rates were improved in all sites. However, urban settings might require extra emphasis to reach high rates of partner attendance compared to smaller rural health centres.