Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
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Integrated Regional Information Networks - November 10, 2006
HARARE, 10 November (PLUSNEWS) - Prevention of mother-to-child transmission (PMTCT) programmes need to involve men in care and support services, says a Zimbabwean HIV/AIDS organisation.
Zvitambo, a research project that aims to improve HIV prevention and care services in Zimbabwe, warned that PMTCT efforts would be futile without fully involving men.
Peter Iliff, medical director of Zvitambo, said his organisation had stepped up efforts to draw men into PMTCT programmes after recognising the benefits of having them on board. When men do play a role, both parties benefit: HIV-positive women are more likely to receive anti-AIDS medication during follow-up visits, avoid breastfeeding their infants, and use condoms; men are more likely to access antiretroviral treatment sooner.
"Since the beginning we have been involving men but they were at the periphery. This time we now see them as equally important," said Iliff.
Over 1,000 public health facilities in Zimbabwe are offering PMTCT services, but the government-sponsored initiative mainly targets women. A single dose of the antiretroviral (ARV) drug, Nevirapine, given to an HIV-positive pregnant woman just before labour, and a few drops administered to the newborn in the first 72 hours, halves the risk of HIV transmission.
Formula feeding reduces the risk of transmission via breast milk by one-third, and women enrolling in the programme are advised to bottle-feed. According to Gladys Chiwome, youth manager for Zimbabwe's Women and AIDS Support Network (WASN), family pressure to breastfeed is strong, and mothers who formula-feed are viewed with suspicion. Involving their partners and husbands in the PMTCT programme could change this. "It does not advance the cause to exclude men from [the] PMTCT programme because women end up isolated, without both the husband and family support," said Chiwome.
Most women choose to keep their HIV positive status a secret from men because they fear being kicked out of home or blamed for passing the virus to their babies. "We have had several cases of women who go to antenatal clinics and get tested, but when they revealed their HIV positive status they were severely assaulted - a thing that would not have happened had the husband been included in the programme in the first place," Chiwome pointed out.
But things are slowly changing for the better. "Our records show a great improvement; many men are now accompanying their wives to antenatal and postnatal clinics, where they get information about ways of preventing infection to their children," said Eddington Mhonda, advocacy officer for the Padare/Men's Forum.
Padare, a local nongovernmental organisation working to change gender stereotypes by reaching boys and men in schools, pubs, sports clubs and churches, has been involved in programmes for the prevention of parent-to-child transmission of HIV since 2004.
Tinashe Muboko (39), who was diagnosed HIV positive five years ago, heard about the risks of transmitting the virus from mother to child during a Padare event. When his wife became pregnant about four years ago, he decided to accompany her to her doctor's appointments, where "the doctors advised me and my wife to give birth by caesarian operation and not to breastfeed him."
Padare also uses social soccer league matches to educate men about PMTCT programmes. Mhonda estimated that since 2004 their PMTCT campaign had reached over 8,000 men, apart from its member base of 5,000 men throughout the country.
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