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Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis

Thesis (MSc)--Stellenbosch University, 2022.

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Main Author: Mmotsa, Tshiamo Moshading
Other Authors: Ngandu, Nobubelo K.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2022
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access_status_str Open Access
author Mmotsa, Tshiamo Moshading
author2 Ngandu, Nobubelo K.
author_browse Mmotsa, Tshiamo Moshading
Ngandu, Nobubelo K.
author_facet Ngandu, Nobubelo K.
Mmotsa, Tshiamo Moshading
author_sort Mmotsa, Tshiamo Moshading
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (MSc)--Stellenbosch University, 2022.
format Thesis
id oai:scholar.sun.ac.za:10019.1/126328
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:44:07.837Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2022
publishDateRange 2022
publishDateSort 2022
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
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source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/126328 Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis Mmotsa, Tshiamo Moshading Ngandu, Nobubelo K. Adetokunboh, Olatunchi O. Nyasulu, Peter Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Epidemiology and Biostatistics. Mother-to-child transmission (pMTCT) Mother-to-child transmission Communicable diseases in pregnancy Antiretroviral agents HIV infections -- Prevention UCTD Thesis (MSc)--Stellenbosch University, 2022. ENGLISH SUMMARY: Elimination of new maternal and infant Human Immunodeficiency Virus (HIV) cases has been a top global priority and various targets have been introduced to end HIV in pregnant, postpartum women and their infants. To achieve these targets, it is important to understand factors related to unfavourable outcomes in the prevention of mother-to-child transmission of HIV (PMTCT, MTCT) programme cascade. The role of a male partner, especially HIV status non-disclosure is one of several important factors. Our study aimed to determine whether not knowing a male partner’s HIV status was a significant risk factor for HIV indicators, including poor HIV clinical outcomes, among pregnant, postpartum women and their infants in the 21 World Health Organization (WHO) priority countries for eliminating MTCT. We conducted a systematic review and meta-analysis of literature through four electronic databases in April 2022 for eligible studies from the 21 WHO priority countries. We included observational studies examining male partner HIV status non-disclosure as a risk factor for HIV indicators in pregnant, postpartum women and their infants conducted after the implementation of the Option B+ treatment policy (i.e., lifelong antiretroviral therapy (ART) regardless of clinical disease status) were included. We conducted a meta-analysis for studies without heterogeneity and assessed the certainty of the evidence assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for each outcome. Forty-six full-text articles were screened and only three articles were included. The included studies were cross-sectional and retrospective cohort studies, conducted in Malawi, South Africa, and Uganda, with a total of 5248 participants. Sub-optimal ART adherence was significantly greater among women who did not know their male partner’s HIV status compared to those who knew the partner’s HIV status (2 studies; n= 3263: Odds ratio (OR) 1.85; 95% confidence interval (CI) 1.49–2.29; P <0.01) with no significant heterogeneity (P = 0.72; I2 = 0%). Complete ART adherence was significantly less among women who did not know their male partner’s HIV status compared to those with knowledge of the partner’s HIV status (1 study; n= 465: OR 0.47; 95% CI 0.32 – 0.69). MTCT was not significantly associated with male partner HIV status non-disclosure (1 study; n= 2881: OR 1.35; 95% CI 0.84 – 2.15). The certainty of evidence from all the studies was low for all outcomes. We found that there was limited evidence to fully understand the role a male partner’s HIV status disclosure plays in the PMTCT cascade. The available studies showed that the likelihood of ART non-adherence was increased by not knowing a male partner’s HIV status, therefore, highlighting the importance of knowing a male partner’s HIV status in the PMTCT cascade. We could not explore the other HIV indicators i.e., MTCT and other clinical outcomes due to the limited and non-availability of primary studies. More and appropriately designed studies within the WHO priority countries are needed urgently to inform policies and interventions for improving male partner involvement. These studies should also include a clear definition of male partner involvement which also highlights HIV testing and male partner disclosure. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2022-11-22T09:40:01Z 2023-01-23T06:52:27Z 2023-05-22T03:00:10Z 2022-12 Thesis http://hdl.handle.net/10019.1/126328 en_ZA Stellenbosch University viii, 55 pages : illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University
spellingShingle Mother-to-child transmission (pMTCT)
Mother-to-child transmission
Communicable diseases in pregnancy
Antiretroviral agents
HIV infections -- Prevention
UCTD
Mmotsa, Tshiamo Moshading
Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis
title Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis
title_full Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis
title_fullStr Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis
title_full_unstemmed Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis
title_short Knowledge of male partner HIV status as a risk factor for HIV indicators in women using prevention of mother-to-child transmission of HIV services in WHO priority countries : a systematic review and meta-analysis
title_sort knowledge of male partner hiv status as a risk factor for hiv indicators in women using prevention of mother to child transmission of hiv services in who priority countries a systematic review and meta analysis
topic Mother-to-child transmission (pMTCT)
Mother-to-child transmission
Communicable diseases in pregnancy
Antiretroviral agents
HIV infections -- Prevention
UCTD
url http://hdl.handle.net/10019.1/126328
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