Testing among male partners, missing link for HIV control —Experts

Experts have identified HIV testing among male partners of pregnant women in Nigeria as a missing link in the elimination of mother-to-child transmission of HIV.

In this study, the researchers assessed male partner testing and the serodiscordance rate among pregnant women and their partners in the prevention of mother-to-child transmission (PMTCT) programme in Nigeria over a five-year period (2012 to 2016).

A serodiscordant relationship, also known as or mixed-status, is one in which one partner is infected with HIV and the other is not. This contrasts with seroconcordant relationships, in which both partners are of the same HIV status.

Over the period, a total of 11,833,062 pregnant women were tested for HIV with a positivity rate of 2.2 per cent. About 266,188 (2.2 per cent) of sexual partners of pregnant women who presented at PMTCT clinics had an HIV test within the period.

The uptake of male partner testing varied across the years, ranging from 22,269 (1.7 per cent) in 2012 to 90,603 (2.9 per cent) in 2014. Overall, the proportion of partners of HIV-negative pregnant women who tested was higher than the proportion of partners of HIV-positive pregnant women (81 per cent versus 19 per cent, respectively).

The serodiscordance rate among partners who tested over the five-year period was 18 per cent. The serodiscordance rate declined from 24 per cent in 2012 to 13 per cent in 2016.

Partner testing in the PMTCT programme in Nigeria has remained low in the last five years while the clinic-based serodiscordance rate among partners appears to be declining.

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The 2018 study in the “International Journal of STD/ AIDS” involved Babayemi O Olakunde at the National Agency for the Control of AIDS in collaboration with Daniel Adeyinka; Tolulope Oladele; and Chamberlain Ozigbu.

There is a need for multilevel interventions to address the possible barriers to partner testing in the PMTCT programme and intensification of the HIV combination prevention approach in the HIV response.

Prevention of mother-to-child transmission (PMTCT) programmes provides antiretroviral treatment (ART) to HIV-positive pregnant women to stop their infants from acquiring the virus.

According to World Health organisation, without treatment, the likelihood of HIV passing from mother-to-child is 15 per cent to 45 per cent. However, ART and other effective PMTCT interventions can reduce this risk to below five per cent.

Around 1.6 million new HIV infections among children have been prevented since 1995 due to the implementation of PMTCT services. Of these, Joint United Nations Programme on HIV/AIDS (UNAIDS), said 1.3 million are estimated to have been averted in the five years, between 2010 and 2015.