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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e3181fdb4c4
Epidemiology and Prevention

Male Antenatal Attendance and HIV Testing Are Associated With Decreased Infant HIV Infection and Increased HIV-Free Survival

Aluisio, Adam MS*; Richardson, Barbra A PhD, MS†‡; Bosire, Rose MBChB, MPH§; John-Stewart, Grace MD, PhD‖¶#; Mbori-Ngacha, Dorothy MBChB, MMed, MPH**; Farquhar, Carey MD, MPH‖¶#

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Abstract

Objective: To investigate the relationship between male involvement in prevention of mother-to-child HIV transmission services and infant HIV acquisition and mortality, a prospective cohort study was undertaken between 1999 and 2005 in Nairobi, Kenya.

Methods: HIV-infected pregnant women were enrolled and followed with their infants for 1 year with infant HIV DNA testing at birth, 1, 3, 6, 9, and 12 months postpartum. Women were encouraged to invite male partners for prevention counseling and HIV testing.

Results: Among 456 female participants, 140 partners (31%) attended the antenatal clinic. Eighty-two (19%) of 441 infants tested were HIV infected by 1 year of age. Adjusting for maternal viral load, vertical transmission risk was lower among women with partner attendance compared with those without [adjusted hazard ratio (aHR) = 0.56, 95% confidence interval (CI): 0.33 to 0.98; P = 0.042] and among women reporting versus not reporting previous partner HIV testing (aHR = 0.52, 95% CI: 0.32 to 0.84; P = 0.008). The combined risk of HIV acquisition or infant mortality was lower with male attendance (aHR = 0.55; 95% CI: 0.35 to 0.88; P = 0.012) and report of prior male HIV testing (aHR = 0.58; 95% CI: 0.34 to 0.88; P = 0.01) when adjusting for maternal viral load and breastfeeding.

Conclusions: Including men in antenatal prevention of mother-to-child HIV transmission services with HIV testing may improve infant health outcomes.

© 2011 Lippincott Williams & Wilkins, Inc.

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