KENYA: Doting dads can lower their children's HIV risk
Few men accompany their wives to the antenatal clinic
Maseno, 7 August 2009 (IRIN) - Jennifer Omasa had lost three children when using traditional birth attendants, so when she fell pregnant a fourth time, she opted to visit her local antenatal clinic in the town of Maseno, western Kenya, and now has an eight-month-old baby girl named Zawadi, Swahili for gift.
Her first visit to the clinic revealed that she was HIV-positive. "I did not know what my fate would be ... I even considered abortion," Omasa told IRIN/PlusNews.
"The nurse asked me to bring my husband for the next visit because I told her I could not disclose such a thing to him. I lied to him that the nurse said they do not disclose the sex of the baby without the presence of both parents."
Her husband, Joab, believed his wife and accompanied her to the clinic, where he was persuaded to take an HIV test that revealed he too was HIV-positive. However, she had received prevention of mother-to-child transmission (PMTCT) services and so far Zawadi has tested negative for HIV.
"I made it my duty to ferry my wife on a bicycle to the clinic every visit day, and I still do it to date," said Joab. "Even though my HIV result was shocking, I have nothing to regret because this child's life is a proof it was worth the sacrifice."
Not enough men visit antenatal clinics
Few men in Kenya accompany their wives on visits to an antenatal clinic, and Joab said he was ridiculed by his peers for doing so. But according to Elizabeth Achola, the PMTCT programme coordinator at Maseno Mission Hospital, women who are supported by their male partners in this way are more likely to consistently visit antenatal as well as postnatal clinics.
"If you look at the trends here [in Maseno], you realize that those mothers who make appearances with their male partners both during initial testing and even after ... are very good in clinic attendance," she said.
"When the male partner is roped in, then both partners get to know their status, and even dangerous practices like forced breastfeeding or forced early weaning are unlikely - the baby's chances of healthy survival are better than when the woman is left all alone."
Achola noted that when HIV-positive pregnant women did not disclose their status to their partners, it was difficult to ensure that they would deliver and raise healthy babies.
"When the mother decides not to disclose her status to the father, the baby's life is in jeopardy," she said. "The possibility of preventing mother-to-child transmission becomes very difficult, because many women decide to deliver with help of traditional birth attendants or quacks."
Achola's experience in Maseno bears out the findings of a study
in the Kenyan capital, Nairobi, which noted reduced HIV risk when the male partner of a pregnant woman attended antenatal clinic visits and was also tested for HIV.
The study enrolled 532 HIV-positive pregnant women, 140 of whom were accompanied by their male partners on antenatal visits; the results showed that the one-year-old children of women whose partners had attended the clinics had an HIV-free survival rate 59 percent higher than those whose partners did not attend.
"These findings indicate that promotion of programmes aimed at increasing male attendance in antenatal care ... could function to reduce the risk of vertical transmission and infant mortality," a research scholar at the University of Nairobi and lead author of the study, Adam Aluisio, told the recent 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa.
About 80 percent of antenatal clinics in Kenya offer PMTCT services, but the uptake of counselling and testing is below 50 percent. The government is considering various incentives, such as waiving maternity fees for couples who attend PMTCT sessions together, to boost male participation.