Male Partner Participation in Antenatal Clinic Services is Associated With Improved HIV-Free Survival Among Infants in Nairobi, Kenya: A Prospective Cohort Study.
Male Partner Participation in Antenatal Clinic Services is Associated With Improved HIV-Free Survival Among Infants in Nairobi, Kenya: A Prospective Cohort Study.
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DOI：
10.1097/qai.0000000000001038
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发表时间：
2016-10-01
期刊：
影响因子：
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通讯作者：
Farquhar C
中科院分区：
文献类型：
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作者：
Aluisio AR;Bosire R;Bourke B;Gatuguta A;Kiarie JN;Nduati R;John-Stewart G;Farquhar C
这项前瞻性研究调查了男性产前诊所（ANC）参与和婴儿无艾滋病毒生存之间的关系。从2009年至2013年，在肯尼亚内罗毕的六个产前诊所（ANC）登记了感染艾滋病毒的孕妇，并随访了她们的婴儿，直到产后六周。通过邀请函鼓励男性伴侣参加产前检查。未参加培训的男性在出生后会收到问卷，让他们自行完成。使用多元回归来确定男性出勤的相关因素。研究了男性参与婴儿艾滋病毒感染结局、死亡率和无艾滋病毒生存的作用。在830名妇女中，519人（62.5%）同意男性参加，136人（26.2%）同意男性参加非国大。在383名（73.8%）伴侣未能出席的女性中，63名（16.4%）通过外展方式接受了调查。在多变量分析中，男性既往HIV检测报告与母体ANC出席率相关（aOR=3.7; 95% CI:1.5-8.9, p=0.003）。501名婴儿中有35名（6.6%）感染艾滋病毒或在6周内死亡。有伴侣陪伴的女性所生婴儿的无hiv生存率（97.7%）显著高于无伴侣陪伴的女性（91.3%）（p=0.01）。与有伴侣陪伴的女性所生的婴儿相比，没有男性陪伴的婴儿死亡或感染的风险大约高出4倍（HR=3.95, 95% CI:1.21-12.89, p=0.023）。调整抗逆转录病毒使用后，没有男性参与的母亲所生婴儿的死亡或感染风险仍然显著更高（aHR=3.79, 95% CI:1.15-12.42, p=0.028）。男性参加ANC与婴儿无艾滋病毒生存率的提高有关。促进男性艾滋病毒检测和参与ANC/PMTCT服务可改善婴儿结局。
This prospective study investigated the relationship between male antenatal clinics (ANC) involvement and infant HIV-free survival. From 2009-2013, HIV-infected pregnant women were enrolled from six antenatal clinics (ANC) in Nairobi, Kenya and followed with their infants until six weeks postpartum. Male partners were encouraged to attend antenatally through invitation letters. Males who failed to attend had questionnaires sent for self-completion postnatally. Multivariate regression was used to identify correlates of male attendance. The role of male involvement in infant outcomes of HIV infection, mortality and HIV-free survival were examined. Among 830 enrolled women, 519 (62.5%) consented to male participation and 136 (26.2%) men attended the ANC. For the 383 (73.8%) women whose partners failed to attend, 63 (16.4%) were surveyed via outreach. In multivariate analysis, male report of prior HIV testing was associated with maternal ANC attendance (aOR=3.7; 95% CI:1.5-8.9, p=0.003). Thirty-five (6.6%) of 501 infants acquired HIV or died by six weeks of life. HIV-free survival was significantly greater among infants born to women with partner attendance (97.7%) than those without (91.3%) (p=0.01). Infants lacking male ANC engagement had an approximately 4-fold higher risk of death or infection compared to those born to women with partner attendance (HR=3.95, 95% CI:1.21-12.89, p=0.023). Adjusting for antiretroviral use, the risk of death or infection remained significantly greater for infants born to mothers without male participation (aHR=3.79, 95% CI:1.15-12.42, p=0.028). Male ANC attendance was associated with improved infant HIV-free survival. Promotion of male HIV testing and engagement in ANC/PMTCT services may improve infant outcomes.