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Male partner 9 letters

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Official invitation letters to promote male partner attendance and couple voluntary HIV counselling and testing in antenatal care: an implementation study in Mbeya Region, Tanzania. However, in. Previous research has suggested written invitation letters as a way to promote male partner involvement. Methods: In this implementation study conducted at three study sites in southwest Tanzania, acceptability of written invitation letters for male partners was assessed.

Pregnant women approaching ANC without a male partner were given an official letter, inviting the partner to attend a joint ANC and couple voluntary counselling and testing CVCT session. Partner attendance was recorded at subsequent antenatal visits, and the invitation was repeated if the partner did not attend. Analysis of socio-demographic indices associated with male partner attendance at ANC was also performed.

Results: Out of women who received an invitation letter for their partner, Beneficial outcomes reported one month after the session included improved client- provider relationship, improved intra-couple communication and enhanced sexual and reproductive health decision-making. Conclusion: Official invitation letters are a feasible intervention in a resource limited sub-Saharan African context, they are highly accepted by couple members, and are an effective way to encourage men to attend ANC and CVCT.

Pre-intervention CVCT rates were improved in all sites. However, urban settings might require extra emphasis to reach high rates of partner attendance compared to smaller rural health centres. Although much progress has been made towards reaching the United Nations Millennium Development Goals 4,5 and 6, many Sub-Saharan African countries still have high HIV incidence, high maternal and infant mortality, high attrition from prevention of mother-to-child transmission of HIV PMTCT services and suboptimal use of health facilities for delivery [1—3].

Male involvement in antenatal care ANC is seen as an increasingly valuable way to improve a number of these health indicators []. Encouraging results from male involvement in ANC have been shown in a number of studies. Male partner involvement MPI has been associated with more women delivering with a skilled birthing assistant [7, 8], and increased condom use is seen when couple voluntary counselling and HIV testing CVCT is included as part of the ANC visit [9, 10].

Furthermore, evidence from qualitative research has shown that the absence of male partner involvement in ANC and PMTCT can create a barrier for women to access these services [11].

In many settings, HIV related health outcomes have been described as poorer for men than for women, with fewer men testing for HIV and more men initiating ART at a more advanced disease stage [16, 17]. Creating a channel for men to gain improved access to health education, VCT, and links to ART could impact on their health outcomes. A shift in perspective of PMTCT from the mother and infant to the family as a complete unit has been shown to improve ART adherence [18], and is recommended as a way for policy makers to encourage the inclusion of more men in HIV programmes [5].

Qualitative research has revealed that although men are generally interested in participating in ANC and PMTCT, in practice, numerous barriers prevent their involvement. Social norms can prevent women from asking their partners to attend ANC or for men to concede to attending [19]. ANC has been considered an arena for women, with predominately female staff, and reports of hostile reactions towards male partners if they attend [20]. Clinic opening hours and long waiting time conflict with male partner work commitments and, for some, the pressure to earn an income is greater than that of attending ANC [20, 21].

Formative research from different sub-Saharan African countries has recommended interventions to increase male partner attendance or involvement, such as opening clinics at evenings. Official written letters of invitation requesting male partner attendance ANC has been reported by both men and women as a good way to encourage male participation.

Invitations are easy and cheap to implement and can overcome social normative barriers by removing the need for women to directly ask their partners to attend ANC, and the official nature of the invite invokes a certain authority which is reported to be respected by male partners [20, , 25].

However, further research is still needed to evaluate the effectiveness of written invitations in different settings [26]. In Tanzania, the national HIV prevalence is 5. An estimated 43, new paediatric HIV infections annually contribute to almost a fifth of all new infections in the country [27]. Given the low rates of MPI and CVCT combined with the increasing need to find effective strategies to improve them, we designed an implementation study to assess the acceptability and effectiveness of written invitations for male partners to attend joint ANC and CVCT in Tanzania.

Secondary objectives of the study include analysis of socio-demographic indices associated with male partner attendance and evaluation of the repercussions of MPI for the women. This implementation study was conducted in Mbeya Region, southwest Tanzania.

Data was collected from a prospective, longitudinal cohort at three health centres at different locations in Mbeya Region. The centres were selected purposively and based on a maximum variation sampling approach to evaluate male involvement in.

All three centres are free of charge, primary health care facilities, offering HIV treatment for the general population, pregnant and breastfeeding women. Early infant diagnosis by PCR is done at the tertiary referral hospital in Mbeya.

Study enrolment was conducted between March and June , during this time women presented for ANC at Ruanda, at Tunduma and at Makongolosi. Prior to the study period few male partners joined their partner for CVCT. Available data from the clinic registers reported that over the preceding three-month period 1. Data from Makongolosi was accessible for male attendance from and showed a rate of Women attending ANC for the first time during their current pregnancy were recruited into the study, after written informed consent had been obtained.

Eligibility criteria included a confirmed pregnancy and general accessibility of the partner, which was assessed by asking the women if their partner was permanently living away from the area or in a health condition that would not allow him accompany her to ANC services.

Women were excluded if their partner attended the first ANC visit with them. Three separate questionnaires were developed for the interviews; these had been pre-tested on clinic attendees and adjusted accordingly by the investigators.

Research assistants were recruited and received training from the principle investigator. In order to prevent the study procedures from interfering with running of the clinic, the research assistants were not routine clinic staff.

Interviews were conducted after routine ANC sessions in a separate room and not in the presence of the ANC nursing staff or the male partner. After attending the first ANC visit, a baseline questionnaire was filled out by a research assistant to gather socio-demographic information about the study participant and their partner, including information about intimate partner violence IPV and knowledge of HIV status. Formal employment was defined as receiving a salary from another body or company.

IPV included any physical, emotional or financial abuse reported by the woman. Results of HIV tests performed within the study sites were not known to the research team, therefore data on participant and partner HIV status' were self-reported by participants. At the end of the baseline interview, women were given a written invitation letter for their male partner. This letter explained that information on pregnancy and parenthood and other important health issues would be given.

It did not state that an HIV test would be offered. The letter was signed by the regional medical officer and was courteous and formal. If the partner attended the next visit as requested, a joint antenatal session would take place during which CVCT was provided, if agreed to, by the couple. After this joint session the research assistant would interview the woman, collecting information about the partner's reaction on receiving an invitation letter and information about the session itself.

CVCT included intensive pre- and post- test counselling of both partners and support in case of any problems during mutual status disclosure. If the partner had not accompanied the woman to this second ANC visit, information was obtained regarding the reasons for his non-attendance and a further letter of invitation was given with a new appointment for a partner session. After the third ANC visit recruited women were again interviewed by the research assistant.

Those who had already been accompanied by their partner at the second visit gave information pertaining to any positive or negative repercussions and longer-term outcomes of the joint session.

Women whose partners had not attended the second visit were asked if they attended at this third visit, and were then interviewed either regarding their opinion on the joint ANC and CVCT session, or regarding reasons for the partner to reject participation.

No additional invitation letter was handed out for non-attending partners after the third visit. During the study period intermittent community sen-sitisation on HIV and PMTCT occurred as part of routine government public health initiatives, which included community leader involvement and radio broadcasts encouraging VCT.

This was the case for all the three study site areas. HIV-positive ANC clients lost to follow-up were routinely traced in community outreach programs in our study setting. To compare data between the women and their partners, two-sample Wilcoxon rank-sum test was used for medians, as the data was non-parametric,. For the bivariate analysis of socio-demographic indices on partner attendance variables, chi-square or Fishers exact test was used depending on the cell value.

A multiple logistic regression model was used for the multivariate analysis of factors associated with partner attendance and included the variables self-reported baseline HIV status, age, marital status, health facility, media exposure, IPV, partner employment and travel time to clinic. In addition to quantitative data, qualitative free-text was recorded to allow participants to expand on events that may have occurred after the joint session.

These open-ended responses were categorised into relevant groups to allow for quantitative assessment. The Mbeya Medical Research and Ethics Committee in Tanzania provided ethical approval for the time period of recruitment, data collection, and follow up. All participants gave informed written consent. The research assistant's training included participant confidentiality, and all data was recorded anonymously. Potential adverse outcomes connected to male involvement CVCT, like increased IPV, were closely screened during our study in order to respond appropriately if needed, and ANC staff was routinely trained in mediation and conflict management during CVCT in these healthcare settings.

Between March and June , women were recruited into the study: 97 at Ruanda health centre, at Tunduma health centre and at Makongolosi dispensary. In total The total male return rate during the study period was The women were aged between 14 and 44 years median 23 and presented at a median gestational week of Many of the socio-demographic indices varied significantly between the health centres Table 1.

Women were oldest in Ruanda with a median age of 24 years at the urban setting Ruanda, and youngest at 22 years in the. The partners of the study participants were aged between 19 and 55 years median 28 , with a median age difference within the couple of four years and relationship duration of three years Table 2.

Between the study sites partner age, literacy, education and employment differed significantly. Bivariate analysis Table 3 was performed to assess the association of socio-demographic indices with partner attendance, Partner attendance was associated with a number of characteristics: women under 26 years of age and married women had significantly higher odds ratios OR of partner attendance respectively: OR 1.

Travel time to clinic was associated with borderline significance OR 1. Formal sector employment of the partner was associated significantly with non-attendance OR 0. Having a radio at home, rather than any other combination of media exposure, and the absence of previous IPV were both significantly associated with partner attendance respectively OR 2. Traveltime to clinic minutes median range 15 1 At baseline, 8 women 2.

Multivariate analysis revealed that partner attendance remained independently associated with being enrolled. Duration of relationship years median range 3 2 0. P value calculated using : cChi-squared test. All other variables lost significance at this stage of the analysis Table 4. Male partners were supportive after having received a written invitation.

Across the three study sites the partner attendance rate was Women attending ANC in Makongolosi showed the highest response, with Of women who had had a partner in attendance at the second visit, attended a follow-up session roughly one month later. These negative events included separation, blame and problems with negotiating safe sex.

I love my male partner – but I yearn to be with a woman

I had sexual experiences with women long ago and feelings of need and loss around this part of my identity are really hitting me now. I love him, like him and we still have an active sex life. However, I have become more and more sure in recent years that I am much more attracted to women.

The effects of HIV self-testing kits in increasing uptake of male partner testing among pregnant women attending antenatal clinics in Kenya: a randomized controlled trial. Introduction: HIV self-testing could add a new approach to scaling up HIV testing with potential of being high impact, low cost, confidential, and empowering for users. Methods: pregnant women attending antenatal clinics ANC and their male partners were recruited in 14 clinics in the eastern and central regions of Kenya and randomly allocated to intervention or control arms at a ratio of

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Search for clues, synonyms, words, anagrams or if you already have some letters enter the letters here using a question mark or full-stop in place of any you don't know e. Definition of lover a person who loves someone or is loved by someone a significant other to whom you are not related by marriage. We've listed any clues from our database that match your search. There will also be a list of synonyms for your answer. The synonyms have been arranged depending on the number of charachters so that they're easy to find.

Partners of people in transition go through their own transitions and may or may not be conflicted as to whether they will remain in their relationship.

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Official invitation letters to promote male partner attendance and couple voluntary HIV counselling and testing in antenatal care: an implementation study in Mbeya Region, Tanzania. However, in. Previous research has suggested written invitation letters as a way to promote male partner involvement. Methods: In this implementation study conducted at three study sites in southwest Tanzania, acceptability of written invitation letters for male partners was assessed.

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Account Options Sign in. Cumulated Index Medicus , Volume 36, Part Selected pages Title Page. Table of Contents. BOOK I. Volume 36 Rockville Pike.

% (without intervention) to 9% (with intervention). with 80% power and prised an invitation letter addressed to the male partner. of the woman attending her.

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