Antenatal Care and Couples’ HIV Testing in Rural Northern Uganda: A Gender Relations Analysis

HIV rates continue to increase among heterosexual couples in many countries including Uganda. This article examines approaches to antenatal care and heterosexual partners’ HIV testing in Amuru subcounty, northern Uganda, drawing on findings derived from fieldwork and interviews. The study findings reveal how institutional structures influence the uptake of HIV testing amid power dynamics, wherein many male partners refuse to be tested. Discussed are the coercive approaches to HIV testing in which couples’ participation in HIV testing is leveraged by connecting testing to future maternity care. This article advances understandings about how heterosexual gender relations at the local, regional, and global levels affect the health of women, men, and families in Amuru subcounty.

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Factors affecting acceptance of HIV testing among antenatal care attendees in Ethiopia: With emphasis on role of male partners

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2010.02.1659 ◽

2010 ◽

Vol 14 ◽

pp. e76-e77

Author(s):

T. Zewde

Keyword(s):

Antenatal Care ◽

Hiv Testing ◽

Male Partners ◽

Factors Affecting

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HIV testing preferences among pregnant women attending antenatal care and their male partners: a discrete choice experiment in Uganda

African Journal of AIDS Research ◽

10.2989/16085906.2019.1686032 ◽

2019 ◽

Vol 18 (4) ◽

pp. 332-340

Author(s):

Jeffrey E Korte ◽

Michael Strauss ◽

Aissatou Ba ◽

Esther Buregyeya ◽

Joseph KB Matovu ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Choice Experiment ◽

Male Partners

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Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

Public Health Nutrition ◽

10.1017/s1368980014001669 ◽

2014 ◽

Vol 18 (16) ◽

pp. 2895-2905 ◽

Cited By ~ 19

Author(s):

Barnabas K Natamba ◽

Hillary Kilama ◽

Angela Arbach ◽

Jane Achan ◽

Jeffrey K Griffiths ◽

...

Keyword(s):

Antenatal Care ◽

Food Insecurity ◽

Pregnant Women ◽

Internal Displacement ◽

Northern Uganda ◽

Cognitive Interviews ◽

Hiv Status ◽

Cross Sectional Survey ◽

Care Clinic ◽

Food Insecurity Access

AbstractObjectiveTo determine the reliability, validity and correlates of measures of food insecurity (FI) obtained using an individually focused food insecurity access scale (IFIAS) among pregnant women of mixed HIV status in northern Uganda.DesignA mixed-methods study involving cognitive interviews nested within a cross-sectional survey.SettingThe antenatal care clinic of Gulu Regional Referral Hospital.SubjectsSurvey respondents included 403 pregnant women, recruited in a ratio of one HIV-infected to two HIV-uninfected respondents, twenty-six (nine of them HIV-infected) of whom were asked to participate in the cognitive interviews.ResultsOver 80 % of cognitive interview participants reported understanding the respective meanings of six of the nine items (i.e. items 4 to 9) on the IFIAS. Two main factors emerged from rotated exploratory factor analysis of the IFIAS: mild to moderate FI (IFIAS items 1–6) and severe FI (items 7–9). Together, they explained 90·4 % of the FI measure’s variance. The full IFIAS and the two subscales had moderate to high internal consistency (Cronbach’s α ranged from 0.75 to 0.87). Dose–response associations between IFIAS scores, and measures of socio-economic status and women’s diet quality, were observed. Multivariate linear regression revealed significant positive associations between IFIAS scores and HIV infection, maternal age, number of children and a history of internal displacement. IFIAS scores were negatively associated with women’s diet diversity score, asset index and being employed.ConclusionsThe IFIAS showed strong reliability, validity and contextual relevance among women attending antenatal care in northern Uganda.

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HIV self-testing alone or with additional interventions, including financial incentives, and linkage to care or prevention among male partners of antenatal care clinic attendees in Malawi: An adaptive multi-arm, multi-stage cluster randomised trial

PLoS Medicine ◽

10.1371/journal.pmed.1002719 ◽

2019 ◽

Vol 16 (1) ◽

pp. e1002719 ◽

Cited By ~ 26

Author(s):

Augustine T. Choko ◽

Elizabeth L. Corbett ◽

Nigel Stallard ◽

Hendramoorthy Maheswaran ◽

Aurelia Lepine ◽

...

Keyword(s):

Antenatal Care ◽

Financial Incentives ◽

Randomised Trial ◽

Linkage To Care ◽

Cluster Randomised Trial ◽

Male Partners ◽

Care Clinic ◽

Cluster Randomised ◽

Multi Stage ◽

Self Testing

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A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04267-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rohan D. Jeremiah ◽

Dhruvi R. Patel ◽

Ellen Chirwa ◽

Esnath Kapito ◽

Xiaohan Mei ◽

...

Keyword(s):

Health Promotion ◽

Hiv Prevention ◽

Reproductive Health ◽

Antenatal Care ◽

Hiv Testing ◽

Late Pregnancy ◽

Sub Saharan Africa ◽

Partner Communication ◽

Logistic Regression Models ◽

Hiv Test

Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.

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The Impact of Couple HIV Testing and Counseling on Consistent Condom Use Among Pregnant Women and Their Male Partners

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001398 ◽

2017 ◽

Vol 75 (4) ◽

pp. 417-425 ◽

Cited By ~ 13

Author(s):

Nora E. Rosenberg ◽

Lauren A. Graybill ◽

Austin Wesevich ◽

Nuala McGrath ◽

Carol E. Golin ◽

...

Keyword(s):

Condom Use ◽

Pregnant Women ◽

Hiv Testing ◽

Consistent Condom ◽

Male Partners ◽

Consistent Condom Use ◽

Hiv Testing And Counseling ◽

Couple Hiv Testing ◽

The Impact ◽

Testing And Counseling

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Design and Development of BACIS Program

Advances in Healthcare Information Systems and Administration - Developing Maternal Health Decision Support Systems in Developing Countries ◽

10.4018/978-1-7998-3958-3.ch007 ◽

2021 ◽

pp. 90-103

Keyword(s):

South Africa ◽

Information System ◽

Maternal Health ◽

Antenatal Care ◽

Maternity Care ◽

Rule Base ◽

Domain Expert ◽

Knowledge Engineer ◽

Improve Compliance ◽

Technical Architecture

The name BACIS combines the names basic antenatal care checklist and information systems. This is to highlight the fact that the BACIS program is an information system that implements the guidelines for maternity care in South Africa and the basic antenatal care checklist process. The BACIS program was conceptualised by the author and the study obstetrician as a tool that could be used at primary healthcare level to improve compliance to maternal health protocols and the BANC checklist. The author's role was that of knowledge engineer and software developer with the study obstetrician acting as the medical domain expert. This chapter presents the technical architecture of the BACIS program. This includes the technology used in creating the system's rule base, as well as the system's data model and software classes and its interface.

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