The Involvement of Male Partners in Care: Socio Determinants of Health Among Women in Prevention of Mother to Child Transmission Program in Malawi

Abstract Background Male partners are rarely present during PMTCT (Prevention-Mother-To-Child-Transmission) services in Sub-Saharan Africa (SSA). The involvement of men is increasingly recognised as an important element of women’s access to care. The study aims to identify the socio-demographic characteristics, HIV-Knowledge, Attitude and Practice (KAP) among women accompanied and not accompanied by the male partners to the facilities. Methods We included pregnant women enrolled in PMTCT programme between August 2018 and November 2019 in the Southern Region of Malawi. Eligible women were aged 18 years or older, lived with a male partner, enrolled for the first time in four DREAM facilities. We provided a KAP survey to women and their partners attending the facilities. Our primary outcome was to assess and analyse the proportion of women who were accompanied by their partner at least once. We applied descriptive statistics, and logistic regressions to study the association between being accompanied and explanatory variables. Results We enrolled 128 HIV-positive women: 82 (64.1%) were accompanied by their male partners and 46 (35.9%) were alone. Women with high level of knowledge on HIV/AIDS are more likely to be accompanied by the male partners (53.7% vs 34.8%, p = 0.040). Level of attitude and practice were not different between women accompanied or not. Patients owning a mean of transport were more likely to go alone to facility (OR 4.16, 95% CI 1.02–16.94). Women who travelled more than 90 minutes to get to the facilities (OR 0.10, 95% CI 0.02–0.49) with high HIV-knowledge (OR 0.38, 95% CI 0.16–0.91) are more likely to be accompanied. Conclusions Our study showed a good male partner involvement compared to other studies performed in SSA. To our knowledge this is the first study showing that women’s knowledge on HIV and healthcare system inequality as geographical accessibility, social class, gender norms and masculinity play a key role on male partner involvement. Therefore, considering the socio determinant of health is crucial to improve the health of all the family.