Support or control? Qualitative interviews with Zambian women on male partner involvement in HIV care during and after pregnancy.

Journal: PloS one

Volume: 15

Issue: 8

Year of Publication: 2020

Affiliated Institutions:  Department of Obstetrics and Gynecology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America. Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia. Department of Obstetrics and Gynaecology, Women and Newborn Hospital, University Teaching Hospitals, Lusaka, Zambia. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America. Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America. Department of Health Behavior and Biological Sciences, Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, Michigan, United States of America. Center for Global Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America.

Abstract summary 

Efforts to promote male partner involvement in the prevention of mother-to-child transmission (PMTCT) may inadvertently exploit gender power differentials to achieve programme targets.We explored women's relative power and perceptions of male partner involvement through interviews with postpartum Zambian women living with HIV (n = 32) using a critical discourse analysis.Women living with HIV reported far-reaching gender power imbalances, including low participation in household decision-making, economic reliance on husbands, and oppressive gendered sexual norms, which hindered their autonomy and prevented optimal mental and physical health during and after their pregnancy. When the husband was HIV-negative, sero-discordance exacerbated women's low power in these heterosexual couples. Male involvement in HIV care was both helpful and hurtful, and often walked a fine line between support for the woman and controlling behaviours over her. Inequities in the sexual divisions of power and labour and gender norms, combined with HIV stigma created challenging circumstances for women navigating the PMTCT cascade.Future programmes should consider the benefits and risks of male partner involvement within specific relationships and according to women's needs, rather than advocating for universal male involvement in PMTCT. This work highlights the persistent need for gender transformative approaches alongside PMTCT efforts.

Authors & Co-authors:  Hampanda Karen M KM Mweemba Oliver O Ahmed Yusuf Y Hatcher Abigail A Turan Janet M JM Darbes Lynae L Abuogi Lisa L LL

Study Outcome 

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Statistics
Citations :  UNAIDS. Global HIV & AIDS statistics—2018 fact sheet. 2018.
Authors :  7
Identifiers
Doi : e0238097
SSN : 1932-6203
Study Population
Male,Women
Mesh Terms
Adult
Other Terms
Study Design
Study Approach
Qualitative
Country of Study
Zambia
Publication Country
United States