Maternal infection with sexually transmitted infections (STIs) during pregnancy is of special concern to health professionals because while mothers are often asymptomatic, the infectious agents can cause irreversible damage to the fetus resulting in in fetal loss, congenital infection, and infant morbidity and mortality. In order to prevent these devastating outcomes in infants, mothers are often screened for STIs during their initial prenatal care visit. However, given that most women continue to engage in high risk sexual behavior during the 40 weeks of gestation, and are less likely to use condoms since they are already pregnant, they can continue to acquire STIs from their sexual partners. In the case of HIV, we have found that acute acquisition of HIV during pregnancy leads to high rates of mother to child transmission, increasing the risk of negative outcomes in both mothers and infants. This trend has also been seen with syphilis, and is likely reflective of mother to child transmission of many perinatally acquired infections. The source of these infection is, of course, the mother's sexual partner. Given this background, we conducted a study in Porto Alegre, Brazil where we successfully enrolled 54% of pregnant women's sexual partners to receive HIV screening via point-of-care rapid testing during the time of prenatal care. This intervention offered men a chance to know their HIV status, and receive treatment if infected to decrease the risk of transmitting HIV to their pregnant partners and infants. In the next 5 years, we hope to gain a better understanding of ways to motivate more men to engage in prenatal care by performing qualitative in depth interviews with men who did participate in partner testing as well as men who did not participate in partner testing, as well as larger-scale quantitative interviews informed by our qualitative work. We will use the data gained from these interviews to create a couples-oriented counseling manual that is more specialized and germane to our difficult to reach male partner populations. We believe that these improved counseling methods will help women develop appropriate strategies to involve their sexual partners in prenatal care and will increase our partner participation rate from 50% (in our original studies) to 75%. Second, we would like to test the acceptability of providing men with a more comprehensive set of services during their visit including point of care testing for HIV, syphilis, gonorrhea, chlamydia, hepatits B and hepatitis C. Furthermore, we will offer men immunizations against Pertussis and Influenza as well as some general handouts on well-baby newborn care. By screening, treating and preventing these infections in the father and improving communication regarding STIs, we believe that we can ultimately improve the health of the father, the mother and the infant. It is Dr. Yeganeh's long term goal to show improved outcomes in mothers and infants with paternal involvement in prenatal care, and she will apply for an RO1 with the preliminary data obtained from this career development period.
Maternal acquisition of sexually transmitted infections and vaccine preventable diseases during pregnancy could lead to poor health outcomes in both the mother and the infant. This study aims to understand how to best involve fathers in prenatal care to screen and treat them for these infections before they infect the mother and infant.
| Yeganeh, Nava; Watts, D Heather; Xu, Jiahong et al. (2018) Infectious Morbidity, Mortality and Nutrition in HIV-exposed, Uninfected, Formula-fed Infants: Results From the HPTN 040/PACTG 1043 Trial. Pediatr Infect Dis J 37:1271-1278 |
| Yeganeh, Nava; Kerin, Tara; Ank, Bonnie et al. (2018) Human Immunodeficiency Virus Antiretroviral Resistance and Transmission in Mother-Infant Pairs Enrolled in a Large Perinatal Study. Clin Infect Dis 66:1770-1777 |
| Adachi, Kristina; Xu, Jiahong; Yeganeh, Nava et al. (2018) Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. PLoS One 13:e0189851 |
| Yeganeh, Nava; Simon, Mariana; Mindry, Deborah et al. (2017) Barriers and facilitators for men to attend prenatal care and obtain HIV voluntary counseling and testing in Brazil. PLoS One 12:e0175505 |
