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A qualitative study of partner engagement in HIV testing in Malawi and Kenya.

Authors
  • Lavender, Tina1
  • Wakasiaka, Sabina2
  • Chimwaza, Angela3
  • Wood, Rebecca4
  • Omoni, Grace2
  • Mukhwana, Raheli5
  • McGowan, Linda4
  • Chimala, Eveles3
  • Omari, Jerusa6
  • Edozien, Leroy7
  • 1 Division of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK.
  • 2 School of Nursing Sciences, University of Nairobi, Nairobi, Kenya. , (Kenya)
  • 3 Kamazu College of Nursing, University of Malawi, Malawi, Malawi. , (Malawi)
  • 4 School of Health Care, University of Leeds, Leeds, UK.
  • 5 Maternity Department, Kenyatta National Hospital, Nairobi, Kenya. , (Kenya)
  • 6 Maternity Department, Kissi Training and Referral Hospital, Kissi, Kenya. , (Kenya)
  • 7 Manchester Academic Health Science Centre and Saint Mary's Hospital, Manchester NHS Foundation Trust, Manchester, UK.
Type
Published Article
Journal
Culture, health & sexuality
Publication Date
Oct 01, 2019
Volume
21
Issue
10
Pages
1131–1145
Identifiers
DOI: 10.1080/13691058.2018.1542509
PMID: 30624135
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In low-income settings, partner engagement in HIV testing during pregnancy is well recognised, but uptake remains low. To understand why men fail to engage, 76 in-depth, individual interviews were conducted with women (n = 23), men (n = 36) and community stakeholders (n = 17) in Malawi and Kenya. Transcribed data were analysed thematically. Male engagement was verbally supported. However, definitions of 'engagement' varied; women wanted a shared experience, whereas men wanted to offer practical and financial support. Women and stakeholders supported couples-testing, but some men thought separate testing was preferable. Barriers to couples-testing were strongly linked to barriers to antenatal engagement, with some direct fear of HIV-testing itself. The major themes identified included diverse definitions of male engagement, cultural norms, poor communication and environmental discomfort - all of which were underpinned by hegemonic masculinity. Couples-testing will only increase when strategies to improve reproductive health care are implemented and men's health is given proper consideration within the process. As social norms constitute a barrier, community-based interventions are likely to be most effective. A multi-pronged approach could include advocacy through social media and community forums, the provision of tailored information, the presence of positive role models and a welcoming environment.

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