PMID- 33057353
OWN - NLM
STAT- MEDLINE
DCOM- 20201127
LR  - 20231112
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 15
IP  - 10
DP  - 2020
TI  - Improving male involvement in antenatal care in low and middle-income countries 
      to prevent mother to child transmission of HIV: A realist review.
PG  - e0240087
LID - 10.1371/journal.pone.0240087 [doi]
LID - e0240087
AB  - BACKGROUND: Childhood Human Immunodeficiency Virus (HIV) infection occurs almost 
      exclusively via mother to child transmission (MTCT) during pregnancy, birth, or 
      through breastfeeding. Recent studies have shown that male involvement (MI) in 
      antenatal care (ANC) and HIV testing, including couples voluntary counselling and 
      testing (CVCT), increases the likelihood that women will adhere to prevention 
      advice and comply with HIV treatment if required during their pregnancy; hence 
      reducing the rates of MTCT of HIV. This realist review investigates how, why, 
      when, and for whom MI in ANC works best to provide contextual advice on how MI in 
      ANC can be best used for prevention of mother to child transmission (PMTCT) of 
      HIV. METHODS: A realist review of existing evidence was conducted. Realist review 
      seeks to explain how and why an intervention works, or does not work, in a given 
      context. This was completed through the five stages of realist synthesis; 
      Eliciting the program theory, search strategy, study selection criteria, data 
      extraction, and data analysis and synthesis. Findings are presented as 
      context-mechanism-outcome (CMO) configurations outlining the mechanisms that work 
      in given contexts to give an outcome. RESULTS: Three CMO configurations were 
      developed. These describe that 1) Couples in monogamous relationships have higher 
      levels of trust, commitment and security leading to increased uptake of PMTCT 
      programs together; 2) ANC spaces that make 'male friendly' adaptions promote 
      normalisation of MI in PMTCT and are more welcoming, leading to increased 
      willingness of male partners to participate in ANC; and 3) couples and 
      communities with higher health literacy encourage increased informed decision 
      making, ownership, and responsibility and thus increased participation in PMTCT 
      of HIV. CONCLUSIONS: The CMOs developed in this review give contextual advice on 
      how one might improve ANC services to increase MI and help reduce MTCT of HIV. We 
      propose that MI in ANC works best where couples are monogamous and trusting, 
      where ANC spaces actively promote being a 'male friendly space' and where there 
      are high levels of community education programs around MTCT.
FAU - Clark, Jacinta
AU  - Clark J
AD  - College of Medicine and Public Health, Flinders University, Adelaide, Australia.
FAU - Sweet, Linda
AU  - Sweet L
AUID- ORCID: 0000-0003-0605-1186
AD  - School of Nursing and Midwifery, Deakin University and Western Health 
      Partnership, Burwood, Australia.
AD  - College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
FAU - Nyoni, Simangaliso
AU  - Nyoni S
AD  - College of Medicine and Public Health, Flinders University, Adelaide, Australia.
FAU - Ward, Paul R
AU  - Ward PR
AD  - College of Medicine and Public Health, Flinders University, Adelaide, Australia.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20201015
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Databases, Factual
MH  - Developing Countries
MH  - Female
MH  - HIV Infections/*pathology/transmission
MH  - Health Literacy
MH  - Humans
MH  - Infectious Disease Transmission, Vertical/*prevention & control
MH  - Male
MH  - *Prenatal Care
MH  - Program Evaluation
PMC - PMC7561142
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/10/16 06:00
MHDA- 2020/11/28 06:00
PMCR- 2020/10/15
CRDT- 2020/10/15 17:32
PHST- 2019/09/04 00:00 [received]
PHST- 2020/09/21 00:00 [accepted]
PHST- 2020/10/15 17:32 [entrez]
PHST- 2020/10/16 06:00 [pubmed]
PHST- 2020/11/28 06:00 [medline]
PHST- 2020/10/15 00:00 [pmc-release]
AID - PONE-D-19-24428 [pii]
AID - 10.1371/journal.pone.0240087 [doi]
PST - epublish
SO  - PLoS One. 2020 Oct 15;15(10):e0240087. doi: 10.1371/journal.pone.0240087. 
      eCollection 2020.