Targeted HIV testing for male partners of HIV-positive pregnant women in a high prevalence setting in Nigeria

• Published in: PloS one Vol. 14; no. 1; p. e0211022
• Main Authors: Gbadamosi, Semiu Olatunde, Itanyi, Ijeoma Uchenna, Menson, William Nii Ayitey, Olawepo, John Olajide, Bruno, Tamara, Ogidi, Amaka Grace, Patel, Dina V, Oko, John Okpanachi, Onoka, Chima Ariel, Ezeanolue, Echezona Edozie
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 30.01.2019; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adult; Age; Age Factors; AIDS; Alcohol use; Alcoholic beverages; Alcohols; Biology and Life Sciences; Communities; Confidence intervals; Control; Demographics; Demography; Disease transmission; Drinking (Alcoholic beverages); Female; Genotypes; Health aspects; Hepatitis; Hepatitis B; Hepatitis B virus; HIV; HIV infections; HIV Seronegativity; HIV tests; HIV-1; Human immunodeficiency virus; Humans; Male; Males; Medical diagnosis; Medical personnel; Medical personnel training; Medicine and Health Sciences; Multivariate analysis; Nigeria - epidemiology; Parents; People and Places; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnant women; Prevalence; Regression analysis; Regression models; Risk factors; Screening; Sex Factors; Sickle cell anemia; Social Sciences; Statistical analysis; Statistical tests; Surveys and Questionnaires; Systematic review; Viruses; Womens health; Workers; Nigeria; Las Vegas Nevada; United States > US; Africa; Tanzania
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0211022

Partner HIV testing during pregnancy has remained abysmally low in sub-Saharan Africa, particularly in Nigeria. Males rarely attend antenatal clinics with their female partners, limiting the few opportunities available to offer them HIV testing. In this study, we evaluated the scale-up of the Healthy Beginning Initiative (HBI), a community-driven evidenced-based intervention to increase HIV testing among pregnant women and their male partners. Our objectives were to determine the: (1) male partner participation rate; (2) prevalence of HIV among male partners of pregnant women; (3) factors associated with HIV positivity among male partners of HIV-positive pregnant women. We reviewed program data of expectant parents enrolled in HBI in Benue State, north-central Nigeria. During HBI, trained lay health workers provided educational and counseling sessions, and offered free onsite integrated testing for HIV, hepatitis B virus and sickle cell genotype to pregnant women and their male partners who participated in incentivized, church-organized baby showers. Each participant completed an interviewer-administered questionnaire on demographics, lifestyle habits, and HIV testing history. Chi-square test was used to compare the characteristics of HIV-positive and HIV-negative male partners. Simple and multivariable logistic regression models were used to determine the association between participants' characteristics and HIV positivity among male partners of HIV-positive women. Male partner participation rate was 57% (5264/9231). Overall HIV prevalence was 6.1% (891/14495) with significantly higher rates in women (7.4%, 681/9231) compared to men (4.0%, 210/5264). Among the 681 HIV-positive women, 289 male partners received HIV testing; 37.7% (109/289) were found to be HIV-positive. In multivariate analysis, older age (adjusted odds ratio [aOR]: 2.45, 95% confidence interval [CI]: 1.27-4.72 for age 30-39 years vs. <30 years; aOR: 2.39, CI: 1.18-4.82 for age ≥40 years vs. <30 years) and self-reported daily alcohol intake (vs. never (aOR: 0.35, CI: 0.13-0.96)) were associated with HIV positivity in male partners of HIV-positive women. The community-based congregational approach is a potential strategy to increase male partner HIV testing towards achieving the UNAIDS goal of 90% HIV screening. Targeting male partners of HIV-positive women for screening may provide a higher yield of HIV diagnosis and the opportunity to engage known positives in care in this population.