Abstract:
Male involvement in antenatal care has been shown to improve health outcomes for
women and infants. However, little is known about how best to encourage male partners
to support essential perinatal health activities. We explored men's perceptions of
facilitators and barriers to involvement in antenatal care and HIV prevention including
fears, hopes and challenges. Forty in-depth interviews were conducted with the male
partners of HIV-positive and HIV-negative pregnant women in southwest Kenya. Most
male partners believed engaging in pregnancy health-related activities was beneficial for
keeping families healthy. However, thematic analysis revealed several obstacles that
hindered participation. Poor couple relationship dynamics seemed negatively to influence
male engagement. Some men were apprehensive that clinic staff might force them to test
for HIV and disclose the results; if HIV-positive, men feared being labelled as
'victimisers' in situations of serodiscordancy, and described fears of abandonment by
their wives. Some men avoided accompanying their wives, citing local culture as
rationale for avoiding the 'effeminate' act of antenatal care attendance. Amidst these
obstacles, some men chose to use their partners' HIV status as proxy for their own.
Findings suggest that improving male engagement in essential maternal and child healthrelated activities will require addressing both structural and interpersonal barriers.