Towards a deeper understanding of male involvement in the prevention of mother to child transmission of HIV in the Bogodogo District of the Central Region of Burkina Faso

PLOS ONE RESEARCH ARTICLE Towards a deeper understanding of male involvement in the prevention of mother to child transmission of HIV in the Bogodogo District of the Central Region of Burkina Faso Maman Joyce Dogba ID1,2,3*, Alice Bila4, Luc Sermé4, Abel Bicaba4, Slim Haddad5 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Quebec, Canada, 2 Université Laval Research Center on Care and Front-Line Services – Pavillon Landry-Poulin, Québec, Canada, 3 Faculté de Médecine, Pavillon Ferdinand-Vandry, Université Laval, Québec, Canada, 4 Société d’Étude et de Recherche en Santé Publique, Ouagadougou, Burkina Faso, 5 Centre de Recherche du CHU de Québec – Université Laval, Québec, Canada * Abstract OPEN ACCESS Citation: Dogba MJ, Bila A, Sermé L, Bicaba A, Haddad S (2022) Towards a deeper understanding of male involvement in the prevention of mother to child transmission of HIV in the Bogodogo District of the Central Region of Burkina Faso. PLoS ONE 17(12): e0277171. https://doi.org/10.1371/journal. pone.0277171 Editor: James Mockridge, PLOS: Public Library of Science, UNITED KINGDOM Received: June 16, 2021 Introduction Men can play crucial roles at each stage of HIV mother-to-child-transmission (MTCT) prevention. Low male involvement in preventative MTCT (PMTCT) in Burkina Faso is partially associated with increased MTCT rates in the country. Male involvement is at the intersection of individual experiences, social locations, organizational and systemic forces. It is crucial that PMTCT interventions are co-designed with all stakeholders, using approaches which account for such interconnected elements. This study, aims to provide a deeper understanding of male involvement using an intersectionality framework. Accepted: October 21, 2022 Published: December 14, 2022 Copyright: © 2022 Dogba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Due the stigmatization experienced by people living with HIV in Burkina Faso and due to the small number of participants included in this study, data can only be accessed upon request directly from authors. Thus data cannot be shared publicly because of the high risk of stigmatization related to an HIVpositive status. Data are available with the Burkina Faso Health Service Research Review Board mentioning the reference number N˚ 2017-12-177 and the CHU de Québec Institutional Review Board Methods We used an intersectional theoretical approach as it positions male involvement at the intersection of social location, systemic forces, individual experiences, and dynamics within couples. We applied an interpretative qualitative description design. The study was performed at St-Camille’s hospital in Ouagadougou, Burkina Faso. Our sample was theoretical to contrast for individual experiences and socioeconomic characteristics. Eligible women were identified via chart review and invited to participate with their male partners. We conducted individual semi-structured interviews with 12 couples. We performed a semantic thematic analysis using QDA Miner to identify themes and patterns among subjective perspectives, while accounting for variations between individuals. Results We interviewed 12 couples; 6 were serodiscordant. All women were HIV-positive. Participant ages ranged from 23 to 48 years. We found male involvement to be multidimensional and multifaceted, covering a large spectrum (from rejection to true partnership) and diverse PLOS ONE | https://doi.org/10.1371/journal.pone.0277171 December 14, 2022 1 / 16 PLOS ONE Towards a deeper understanding of male involvement in the prevention of mother to child transmission of HIV with the following reference number: Projet 20173197 / Renouvellement F9 – 26065) for researchers who meet the criteria for access to confidential data. involvement. Male involvement was limited by competing priorities, contradictory expectations, organizational opportunities and societal beliefs. We found interactions with caregivers impacted male involvement. Funding: This research was supported by a grant (number Ga-03-2015F) from the Innovating for Maternal and Child Health in Africa Initiative – a partnership between Global Affairs Canada (GAC), the Canadian Institutes of Health Research (CIHR) and Canada’s International Development Research Centre (IDRC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conclusion This study contributed to enhancing our understanding of male involvement in PMTCT of HIV as a dynamic result of the interconnected individual, organizational and systemic experiences. Increasing male involvement will require implementation of coordinated interventions. Such interventions must strive to simultaneously integrate individual, organizational and systemic actions together. Competing interests: The authors have declared that no competing interests exist. Abbreviations: HIV, human immunodeficiency virus; MTCT, Mother to child transmission; PMTCT, Preventative mother to child transmission. Background Men can play crucial roles at each stage of HIV mother-to-child-transmission (MTCT) prevention [1]. The “man” in ‘male involvement’ refers to either the biological father or the current male partner of the pregnant woman. The “ideal” man has been portrayed as present, accessible, understanding, willing to learn more about the progress of the pregnancy, emotionally supportive of the woman (accompanying her to prenatal care, discussing breastfeeding options) [2], and/or providing financial support (paying for prenatal and postnatal care) [3, 4]. Male involvement can facilitate a woman’s access to and utilization of preventative motherto-child transmission (PMTCT) programs [5, 6], particularly counselling services [6], secure childbirth and breastfeeding practices [7–9]. Burkina Faso, however, is far from its targeted male involvement objectives in PMTCT [10]. In fact, recent studies in Burkina Faso noticed gradual increases in residual MTCT rates from 5.30% in 2014 to 5.94%, and 8.20% in 2015 and 2016 respectively [10]. With only 2.90% of male partners screened through PMTCT programs, low male involvement in the country has been partially attributed to this trend and thus, has become a priority for more effective PMTCT in the country (Plan ETME 2017–2020) [11]. Barriers to male involvement in Burkina Faso, as is the case in many African countries, include sociocultural norms and beliefs, taboos, insufficient space dedicated to male partners in health care centers [12, 13] unfriendly care providers behavior [13, 14], fear of being informed of an HIV-positive status [14], and long waiting (...truncated)