1. Male engagement strategies effective in improving Option B+ retention in rural Mozambique
Carolyn M. Audet*; Erin Graves; Magdalena Bravo; Muktar H. Aliyu; Maria Fernanda Sardella Alvim; Ann F. Green; Yazalde Manuel Chire
*presenting author
Supported by National Institutes of Health/National Institute of Mental Health K01 MH ,
and CDC (PEPFAR): Cooperative agreements # U2GGH and # U2GGH001943

2. Figure 1. Male Engagement Strategy
OBJECTIVES
To compare rates of retention among pregnant women and their male partners living with HIV in rural Mozambique who receive the male engagement strategy (MES) intervention vs. those receiving standard of care (SOC).
METHODS
Retrospective cohort study of women (≥15 years old) enrolled in HIV care and treatment through PMTCT services ( )
112 PEFPAR supported sites; 6500 pregnant women
Friends in Global Health Mozambique
TBA counsels pregnant woman
Seeks permission to contact partner
Pregnant woman visits Traditional Birth Attendant (TBA)
TBA contacts Male Champion
Male Champion visits male partner
TBA accompanies couple to health facility
Couple counseled and tested together
Couple attends 1st Prenatal Care visit together
Male Champion conducts home visits
TBA accompanies mother and infant to EID
Home-based follow up
Figure 1. Male Engagement Strategy

3. MORTALITY HIV DIAGNOSIS CLINIC ENROLLMENT ART INITIATION RETENTION
RESULTS
N = 6,500 pregnant women
N = 727 male partners
Figure 2: Pregnant women have 23% lower hazard risk [0.77 (0.69, 0.86)] of ever missing medication pick up during the first 6 months of care in MES sites (adjusting for district, education, marital status, language, BMI and CD4 cell count).
Figure 3: Women who enroll at an MES site that has been operating for at least 7 months are 29% less likely to miss medication pick up than those not in MES sites.
Figure 2: ART LTFU among women at MES vs. Non-MES sites
Figure 3: ART LTFU by duration of MES implementation
MORTALITY
HIV DIAGNOSIS
CLINIC ENROLLMENT
ART INITIATION
RETENTION
PMTCT
VCT
Other
<4 of 6 monthly visits attended in
6 months
no contact for >=60 days
from last ART refill
Only patients who
enrolled in clinic
are included
Referral Source
Pre-ART LTFU
Post-ART LTFU
Time to ART Initiation
CD4 at Enrollment

4. CONCLUSIONS IMPLICATIONS
The male engagement strategy employed in rural Zambézia province has resulted in significant improvements in the retention of pregnant women on ART.
Women who attended MES clinics were more likely to remain in care at 6 months in comparison with those attending SOC clinics.
The longer a clinical site was included in the MES strategy, the better the retention of pregnant women.
Impact on male partner uptake of ART and retention in HIV care (if positive) is less clear and needs to be investigated.
Engaging male partners is an important component in any ANC service.
Community-based services are essential to overcoming local norms and stigma surrounding male engagement in women’s health.
IMPLICATIONS
6.0%: 95%CI %
1.6%: 95%CI %