Male partner's involvement in prevention of mother-to-child transmission (PMTCT) of HIV and associated factors in Gofa Zone, Southern Ethiopia: a community-based cross-sectional study.

Background: Male partner involvement is recognised as an important strategy to boost prevention of mother-to-child transmission (PMTCT) of HIV. However, in Ethiopia, data on male perspectives and the role of legal and service-level factors that influence involvement are limited. Method: We conducted a community-based cross-sectional study in Gofa Zone from 17 June to 21 August 2021. Using stratified multistage random sampling, 596 male partners whose female partners were pregnant or had given birth within the previous 6 months were interviewed with a structured questionnaire. A 6-item index measured male involvement; we used bi-variable and multivariable logistic regression to identify factors associated with involvement (reported as adjusted ORs (AOR) with 95% CI). Result: Male involvement (score ≥4/6) was 32.2% (192/596; 95% CI 28.5 to 36.1). Higher education (secondary or above: AOR 2.9; 95% CI 1.35 to 6.35) and good PMTCT knowledge (AOR 5.51; 95% CI 3.11 to 9.77) were positively associated with involvement. Beliefs that pregnancy is solely a woman's responsibility (AOR 0.43; 95% CI 0.24 to 0.76), perception that PMTCT clinics serve only women (AOR 0.37; 95% CI 0.21 to 0.65), long waiting times (AOR 0.34; 95% CI 0.19 to 0.61) and perceived absence of legal or policy support encouraging male involvement (AOR 0.31; 95% CI 0.17 to 0.57) were negatively associated with involvement. Conclusion: Male involvement in PMTCT in this setting remains suboptimal. Interventions to increase knowledge, address sociocultural norms and make services more male-friendly may improve male involvement in HIV PMTCT services.