Impact of a Rapid Results Initiative Approach on Improving Male Partner Involvement in Prevention of Mother to Child Transmission of HIV in Western Kenya

Abstract

A rapid results initiative (RRI) aimed at increasing male involvement in prevention of mother-to-child transmission (PMTCT) and service uptake among pregnant women at 116 antenatal clinics in Western Kenya was compared at baseline, during the RRI, and 3-months post-RRI. Male involvement increased from 7.4 to 54.2% during RRI (risk difference [RD] 0.47, CI 0.45–0.48) then 43.4% post-RRI (RD 0.36, CI 0.35–0.37). Among HIV-infected women, facility delivery increased from 40.0 to 49.9% (RD 0.10, 95% CI 0.06–0.13) and 65.0% post-RRI (RD 0.25, 95% CI 0.22–0.28). HIV-infected pregnant women linkage to HIV care increased from 58.6 to 85.9% (RD 0.27, CI 0.24–0.30) and 97.3% post-RRI (RD 0.39, CI 0.36–0.41). Time to ART initiation reduced from 29 days (interquartile range [IQR] 6–56) to 14 days (IQR 0–28) to 7 days (IQR 0–20). A male-centered RRI can significantly increase men’s engagement in antenatal care leading to improved partner utilization of PMTCT and antenatal services.

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Acknowledgements

We thank the Kenyan women and men who participated in the study. We acknowledge the important logistical support of the KEMRI-UCSF Collaborative Group and especially Family Aids Care and Education Services (FACES). We gratefully acknowledge the Director of KEMRI, the Director of KEMRI’s Centre for Microbiology, and the Nyanza Provincial Ministries of Health and the provincial and district reproductive health coordinators for their support in conducting this research. We also thank George Owino, Christine Osula, Benta Aloo, Jannes Kodero, and Charles Odoyo for their important contributions to this research. This publication was made possible by financial support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through cooperative Agreement, #PS001913 through the U.S. Centres for Disease Control and Prevention (CDC), Division of Global HIV and TB (DGHT). The findings and conclusions in this publication are those of the author(s) and do not necessarily represent the official position of the CDC/Government of Kenya.

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Correspondence to E. Akama.

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Ethical Approval

For this analysis, the program evaluation protocol that allows Family Aids Care and Education Services (FACES) to utilize routinely gathered medical information for program evaluation and dissemination was reviewed and approved by the KEMRI ethical review committee, CDC, and the UCSF Committee on Human Research. In addition, informed consent was not obtained from particiants because these were routine services accessible to all patients at the health facility. To protect patient privacy, all data were de-identified, and access to patient records restricted to authorized health workers.

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Akama, E., Mburu, M., Mutegi, E. et al. Impact of a Rapid Results Initiative Approach on Improving Male Partner Involvement in Prevention of Mother to Child Transmission of HIV in Western Kenya. AIDS Behav 22, 2956–2965 (2018). https://doi.org/10.1007/s10461-018-2140-3

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Keywords

  • Rapid results initiative
  • Male involvement
  • PMTCT
  • HIV-1
  • Kenya