Introduction: Although the HIV epidemic has stabilized worldwide, it remains a public health challenge in sub-Saharan Africa. The key strategy to prevention and control of HIV remains voluntary counseling and testing. In sub-Saharan Africa, 76% of pregnant women have at least one antenatal visit. Therefore, antenatal care is a venue through which women can access HIV testing, and, if infected, obtain care for prevention of mother-to-child transmission (PMTCT). Public health organizations have promoted increasing HIV testing of men by incorporating partner testing into antenatal care. Recent studies have shown that African women may not be receptive to their partner's involvement in obstetric care secondary to cultural attitudes and traditional beliefs.
Methods: A quality improvement project surveyed women to identify their attitudes and beliefs concerning antenatal care, PMTCT, and partner's participation in antenatal care and testing.
Results: Women viewed antenatal care as important to having a positive pregnancy outcome and the primary venue through which they accessed HIV testing. Most women (83.8%) were receptive to their partners’ involvement in antenatal care and identified increased partner participation over the past 5 years. Women (98.2%) said men's primary role was payment for obstetric care. Cultural and gender-based attitudes and beliefs were identified as barriers to HIV testing of men.
Discussion: Women viewed antenatal care as important to a positive pregnancy outcome with access dependent on their families’ finances and their partners’ ability and willingness to pay for their care. Although pregnancy has traditionally been viewed as a women's affair, the majority of women wanted their partners to participate in their care, including receiving HIV counseling and testing. Women identified men's involvement as an individual belief, saying that many in their community were not supportive of male participation in antenatal care. Multiple options, including couples testing in antenatal clinics, should be available to increase HIV testing in men.