What Works for Women and Girls

health facilities have traditionally excluded men even though fatherhood is important in almostall societies and women often want the support of their male partners during pregnancy, labor,delivery and the postpartum period. Good maternal health can also be highly dependent onaccess to HIV prevention, treatment and care for men, as focusing on men in addition towomen protects the health of women and, by extension, their children.Involving men in PMTCT programs—with the permission of women—is an importantcomponent in increasing women’s uptake of HIV testing, prevention, treatment and care(Ghanotakis, 2010). Yet in 2007, only 5% of the male partners of women attending antenatalcare were tested for HIV (UNAIDS, 2009e). Involving men in PMTCT programs can also helpaddress the gender issues that impact women’s acquisition of HIV, as well as access to prevention,testing, treatment and care. [See also Chapter 11. Strengthening the Enabling Environment]Recent work has focused on men and fatherhood (Barker et al., 2010). Programs such asWomen Fighting AIDS in Kenya is successfully working to increase male involvement inPMTCT services (Ovaro and Kaduwa, 2008). A number of programs, such as EngenderHealth’sMen as Partners or Catholic Medical Mission Board’s Men Taking Action in Zambia are workingto increase the positive involvement of men in maternal health care in general, but few evaluatedstudies were found for PMTCT programs. PMTCT programs may learn from involvingmen in safe motherhood programs. Interventions related to this pillar are included in Chapter7. Treatment, Chapter 10. Preventing, Detecting and Treating Critical Co-Infections, and Chapter 12.Care and Support.Most PMTCT Programs Focus On Pillar 3Despite the importance of pillars one and two in preventing vertical transmission, “for mostprograms in the field, PMTCT is in fact focused on the program’s third and fourth components”(Msellati, 2009:808). While this chapter touches on pillar two, additional information onpreventing unintended pregnancies is in Chapter 8. Meeting the Sexual and Reproductive HealthNeeds of Women Living With HIV. The majority of this chapter focuses on pillar three—safemotherhood and prevention of vertical transmission. The other pillars are covered, however, inadditional chapters as noted above.What Works in Safe Motherhood and Preventing VerticalTransmissionA number of proven strategies work to reduce the risk of HIV transmission from mother tochild. Confidential HIV testing with counseling during antenatal care that includes women,and with their permission, their partners, is a critical foundation for reducing vertical trans-208 CHAPTER 9 SAFE MOTHERHOOD AND PREVENTION OF VERTICAL TRANSMISSION