Integrated Regional Information Networks - January 16, 2012
KISUMU, 16 January 2012 (PlusNews) - Involving men is
increasingly being promoted as a key element in the prevention of
mother-to-child transmission of HIV, and while its benefits are
well-documented - in one Kenyan study it reduced the risks of
vertical transmission and infant mortality by more than 40
percent compared with no involvement - it can occasionally lead
to domestic discord and even violence.
Silvia*, a 33-year-old mother of six, now living at her mother's
home in western Kenya, says her 14-year marriage was doomed the
minute she followed her healthcare worker's advice to bring her
husband for an antenatal visit after she tested HIV-positive. "I
was tested and I was told I was positive; I asked if I could go
ahead and just carry the pregnancy and the nurse assured me it
was fine," she said. "She, however, asked me to bring my husband
when coming for the next visit and I agreed."
She convinced her husband to accompany her on her next visit, but
when he tested HIV-negative, he accused her of cheating on him.
"He left me at the hospital... When I got home, he beat me up and
said the child I was carrying wasn't his and he chased me away,"
she added. "The nurse thought she was helping us but it turned
out to be a curse for me."
There is limited research into the area of gender-based violence
following HIV-testing, but a presentation by the NGO, the Sonke
Gender Justice Network, at the 2010 International AIDS Society
conference in Vienna, Austria, reported that women's experiences
upon disclosing their status to their male partners were often
"complex and positive": some studies reported violence levels of
up to 14 percent, while others stated that about half of
HIV-positive women said their partners reacted supportively to
According to Beatrice Misoga, PMTCT programme officer with the
AIDS Population Health Integrated Assistance (APHIA Plus),
gender-based violence is more common in discordant relationships
where the man is HIV-negative. "Male involvement has helped
realize success with PMTCT programmes where it has been applied
because prevention of mother to child transmission is a family
issue, but yes, there have been challenges in certain aspects
like the possibility of gender-based violence targeting women and
more so in a situation where the male partner is not willing to
be part of it."
In 2009, Human Rights Watch (HRW) cautioned the Kenyan government
to ensure that human rights were protected during a large-scale
home-based counselling and testing programme; HRW noted that
HIV-positive mothers - among them girls under the age of 18 -
sometimes suffered violence, mistreatment, disinheritance, and
discrimination from their husbands, in-laws, or their own
Some women, too fearful of the repercussions of revealing their
HIV status to their husbands, opt out of PMTCT programmes
altogether. "A woman comes to the facility but the moment you
mention her man, she disappears and might resurface to give birth
- some go to traditional birth attendants," said Julie Miseda, a
nurse at Nyanza Province's Siaya District Hospital. "Some will
tell you they are not married but the day they give birth, a man
appears and claims he is the father.
"At times, involving both of them creates tension between them
and they tend to keep very crucial information, for example, a
history of a sexually transmitted infection, to themselves," she
According to APHIA Plus's Misoga, to preserve the benefits of
male involvement in PMTCT, health clinics had to become more
aware of the counselling needs of men. "Despite the
disadvantages, the benefits of male involvement are immense and
what needs to be done is to make these antenatal clinics male
friendly. It is also important to give constant information and
messages targeting men on the need to be part of prevention of
mother to child transmission programmes," she said.
Christopher Mukabi, a local peer educator, says male support
groups have proved useful in improving the way couples deal with
an HIV diagnosis. "Bringing men together in male support groups
and then using these groups to convince them to get into PMTCT
programmes can help deal with some of the challenges, but stigma
and alcoholism are still problems in getting men involved."
*Not her real name