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Sex Transm Dis. 2019 Nov;46(11):716-721. doi: 10.1097/OLQ.0000000000001057.

Male Partner Linkage to Clinic-Based Services for Sexually Transmitted Infections and Human Immunodeficiency Virus Services Following Couple Home-Based Education and Testing.

Author information

1
From the Department of Epidemiology, University of Washington, Seattle, WA.
2
Department of Research and Programs.
3
Department of Reproductive Health, Kenyatta National Hospital.
4
Department of Obstetrics and Gynaecology, University of Nairobi.
5
Computer Science and Engineering and Public Health.
6
Department of Public, Health University of Washington, Seattle, WA.
7
Allina Health, Minneapolis, MN.
8
Department of Biostatistics.
9
Department of Global Health.
10
Department of Medicine, University of Washington, Seattle, WA.

Abstract

BACKGROUND:

Home-based human immunodeficiency virus (HIV) testing and education has increased HIV test uptake and access to health services among men. We studied how a home-based antenatal intervention influenced male partner utilization of clinic-based HIV and sexually transmitted infection (STI) services, linkage to HIV care and medical circumcision.

METHODS:

We conducted a secondary analysis within a randomized controlled trial of pregnant women attending antenatal care in Kenya. Women and their male partners received either a home-based couple intervention or an invitation letter for clinic-based couple HIV testing. The home-based intervention included education on STI symptoms, STI and HIV treatment and male circumcision for HIV prevention. Male self-reported outcomes were compared using relative risks at 6 months postpartum.

RESULTS:

Among 525 women, we reached 487 (93%) of their male partners; 247 men in the intervention arm and 240 men in the control arm. Men who received the intervention were more likely to report an STI consultation (n = 47 vs. 16; relative risk, 1.59; 95% confidence interval, 1.33-1.89). Among 23 men with newly diagnosed HIV, linkage to HIV care was reported by 4 of 15 in the intervention (3 men had missing linkage data) and 3 of 5 men in the control arms (relative risk, 0.66; 95% confidence interval, 0.34-1.29). Although the intervention identified 3 times more men with new HIV infection, the study lacked power to find significant differences in linkage to HIV care. Few eligible men sought medical circumcision (4 of 72 intervention and 2 of 88 control).

CONCLUSIONS:

Home-based couple education and testing increased STI consultations among male partners of pregnant women, but appeared insufficient to overcome the barriers involved in linkage to HIV care and medical circumcision.

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