Efforts to prevent mother-to-child HIV transmission (PMTCT) in sub-
Saharan Africa have focused overwhelmingly on women, to the unintended
exclusion of their male partners. A cross-sectional study was conducted in
Tshwane, South Africa, to determine barriers to male-partner participation
during PMTCT. In-depth interviews were conducted with 124 men whose
partners had recently been pregnant, and five focus group discussions were
held with physicians, nurses, HIV counselors, and community representatives.
Qualitative analysis revealed that while most fathers believed that
HIV testing is an important part of preparing for fatherhood, there are
formidable structural and psychosocial barriers: the perception of clinics as
not “male-friendly,” a narrow focus on HIV testing instead of general wellness,
and a lack of expectations and opportunities for fathers to participate
in health care. Coupled with more family-oriented approaches to PMTCT,
measurable improvements in the way that male partners are invited to and
engaged in HIV prevention during pregnancy can help PMTCT programs to
achieve their full potential.