"Male involvement" in women and children's HIV prevention: Challenges in definition and interpretation
To the Editors:
The study by Alusio et al (J Acquir Immune Defic Syndr. 2011;56:76-82)1 presents biological evidence for a beneficial effect from male partner engagement with HIV health services on the prevention of pediatric HIV in east Africa. For more than 2 decades, multilateral agencies have published statements and codified action plans endorsing men's responsibility and participation in the health and well-being of women and children.2-4 The latest Global Report published by the Joint United Nations Programme on HIV/ AIDS (UNAIDS) emphasizes the importance of engaging men in the global HIV response.5 Efforts to enroll couples in HIV prevention and treatment interventions6 and expand couples HIV counseling and testing (HCT)7,8 (an objective of the current President's Emergency Plan for AIDS Relief reauthorization) reflect heightened awareness of the link between sex dynamics and HIV risk. Included in this is an implicit acknowledgment of the reality, well described by ethnographers, that men are the traditional sexual and reproductive health decision makers in many parts of Africa....