TITLE

Mistrust in marriage-Reasons why men do not accept couple HIV testing during antenatal care- a qualitative study in eastern Uganda

AUTHOR(S)
Larsson, Elin C.; Thorson, Anna; Nsabagasani, Xavier; Namusoko, Sarah; Popenoe, Rebecca; Ekström, Anna Mia
PUB. DATE
January 2010
SOURCE
BMC Public Health;2010, Vol. 10 Issue 1, p769
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: A policy for couple HIV counseling and testing was introduced in 2006 in Uganda, urging pregnant women and their spouses to be HIV tested together during antenatal care (ANC). The policy aims to identify HIVinfected pregnant women to prevent mother-to-child transmission of HIV through prophylactic antiretroviral treatment, to provide counseling, and to link HIV-infected persons to care. However, the uptake of couple testing remains low. This study explores men's views on, and experiences of couple HIV testing during ANC. Methods: The study was conducted at two time points, in 2008 and 2009, in the rural Iganga and Mayuge districts of eastern Uganda. We carried out nine focus group discussions, about 10 participants in each, and in-depth interviews with 13 men, all of whom were fathers. Data were collected in the local language, Lusoga, audiorecorded and thereafter translated and transcribed into English and analyzed using content analysis. Results: Men were fully aware of the availability of couple HIV testing, but cited several barriers to their use of these services. The men perceived their marriages as unstable and distrustful, making the idea of couple testing unappealing because of the conflicts it could give rise to. Further, they did not understand why they should be tested if they did not have symptoms. Finally, the perceived stigmatizing nature of HIV care and rude attitudes among health workers at the health facilities led them to view the health facilities providing ANC as unwelcoming. The men in our study had several suggestions for how to improve the current policy: peer sensitization of men, make health facilities less stigmatizing and more male-friendly, train health workers to meet men's needs, and hold discussions between health workers and community members. Conclusions: In summary, pursuing couple HIV testing as a main avenue for making men more willing to test and support PMTCT for their wives, does not seem to work in its current form in this region. HIV services must be better adapted to local gender systems taking into account that incentives, health-seeking behavior and health system barriers differ between men and women.
ACCESSION #
57831849

 

Related Articles

  • Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa. Rice, Brian D.; Bätzing-Feigenbaum, Jörg; Hosegood, Victoria; Tanser, Frank; Hill, Caterina; Barnighausen, Till; Herbst, Kobus; Welz, Tanya; Newell, Marie-Louise // BMC Public Health;2007, Vol. 7 Issue 1, p160 

    Background: To present and compare population-based and antenatal-care (ANC) sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such...

  • Does uptake of antenatal HIV testing depend on the individual midwife? Cross sectional study. Jones, Simon; Sadler, Tonya; Low, Nicola; Blott, Maggie; Welch, Jan // BMJ: British Medical Journal (International Edition);01/24/98, Vol. 316 Issue 7127, p272 

    Examines the effect of midvives' characteristics and site and duration of antenal human immunodeficiency virus (HIV) infection testing in an area of high seroprevalence. Identification of the area; Subjects used in the study; Methodology; Circumstances under which HIV testing was twice as...

  • Maximising the global use of HIV surveillance data through the development and sharing of analytical development and Sharing of Analytical tools. Garnett, G. P.; Grossly, N. C.; Boermo, J. T.; Ghys, P. D. // Sexually Transmitted Infections;Aug2004 Supplement 1, Vol. 80, pi1 

    To improve health it is important that care and prevention activities are focused on real problems and real need. Rational decisions about health strategies and interventions should be based on reliable and timely knowledge of the distribution of disease, which is only available with good...

  • Antenatal screening for HIV enhanced. Topham-Kindley, Liane // New Zealand Doctor;7/13/2005, p18 

    Reports on routine antenatal HIV screening to be implemented by the New Zealand Ministry of Health in the country. Basis of the screening policy; Reactions from the health sector; Views of College of Midwives chief executive Karen Guilliland on the effect of the policy on the tasks of midwives.

  • HIV Testing Among U.S. Women During Prenatal Care: Findings from the 2002 National Survey of Family Growth. Anderson, John E.; Sansom, Stephanie // Maternal & Child Health Journal;Sep2006, Vol. 10 Issue 5, p413 

    Objectives: To measure progress toward the US Public Health Service recommended goal that HIV screening be part of the routine battery of prenatal tests for all pregnant women, using data from a nationally-representative reproductive health survey. Methods: Data from the 2002 National Survey of...

  • Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia. Zyaambo, Cosmas; Siziya, Seter; Fylkesnes, Knut // BMC Health Services Research;2012, Vol. 12 Issue 1, p389 

    Background: With regards to equity, the objective for health care systems is "equal access for equal needs". We examined associations of predisposing, enabling and need factors with health facility utilization in areas with high HIV prevalence and few people being aware of their HIV status....

  • Reducing vertical transmission of HIV in the UK. Nicoll, Angus; Peckham, Catherine // BMJ: British Medical Journal (International Edition);11/06/99, Vol. 319 Issue 7219, p1211 

    Provides information on the plan of the government of Great Britain to offer an antenatal HIV test which is aimed to reduce perinatal transmission of HIV. Statistics on the epidemic; Terms of the plan; Implication of the plan.

  • Factors affecting uptake of antenatal HIV testing in London: Results of a multicentre study. Gibb, Diana M.; MacDonagh, Sandra E.; Gupta, Ramyani; Tookey, Pat A.; Peckham, Catherine S.; Ades, A.E. // BMJ: British Medical Journal (International Edition);01/24/98, Vol. 316 Issue 7127, p259 

    Presents a study which sought to measure the uptake of antenatal human immunodeficiency virus (HIV) testing, in addition to determining its relation to risk of HIV and to screening practices. Subjects used for the study; Methodology of study; Results obtained; Discussion of results.

  • Review of uptake of interventions to reduce mother to child transmission of HIV by women... Lyall, E.G. Hermione; Stainsby, Christopher; Taylor, Graham P.; Ait-Khaled, Mounir; Bingham, Samantha; Evans, Jennifer A.; Wright, Anne; Weber, Jonathan N.; McClure, Myra O.; Walters, Sam; Tudor-Williams, Gareth // BMJ: British Medical Journal (International Edition);01/24/98, Vol. 316 Issue 7127, p268 

    Presents a study which examined the change in uptake of interventions to reduce transmission of human immunodeficiency virus (HIV) from mothers to infants from January 1994 to July 1997 in central London, England. Review of mother-infant pairs presented for infant diagnosis of HIV infection;...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics