"Men don't think that far"- Interviewing becoming fathers in Sweden about chlamydia and HIV testing during pregnancy

Background In Europe, pregnant women are offered tests for HIV, syphilis and hepatitis, as part of the routine checks and the motive is to protect mother-to-child transmission. The concept was coined by WHO and in their... [ view full abstract ]

Background In Europe, pregnant women are offered tests for HIV, syphilis and hepatitis, as part of the routine checks and the motive is to protect mother-to-child transmission. The concept was coined by WHO and in their document about a strategic vision regarding HIV, surprisingly little is mentioned about testing men. Despite increasing research into men’s experience of pregnancy and fatherhood, in the western world less is written about expectant fathers’ perceptions of screening men for STIs during pregnancy. We used qualitative research design to discursively explore expectant fathers’ perceptions of chlamydia and HIV, and their masculinity constructions about testing, and explored how they talked about their potential resistance towards testing and their pre-test emotions.  

Method Twenty men were offered chlamydia and HIV testing at the beginning of their partner’s pregnancy. Those who agreed to be tested were interviewed in-depth; those who declined testing were also interviewed. The interviews were tape recorded and transcribed verbatim. The analysis was inspired by discourse analysis on masculinity.

Results Three discursive themes: Men prefer to suppress their vulnerability to STIs, Body and biology differ between men and women and Men have mixed emotions around STI testing underscore the informants’ conversations and sometimes conflicting thoughts about STI testing. Most of these men did not mind being STI tested, even if they had mixed emotions around testing.

Discussion The majority of men talked about pregnancy as a feminine territory,  raised uncertainties about men’s roles in the transmission of STIs, and talked about women’s and men’s essentially different bodies and biology, where few men realised that they could infect both their partner and the unborn child.

Conclusion This knowledge gap that men have must become apparent to healthcare providers, and policy makers must give men equal access to the reproductive arena. We advocate a more comprehensive approach to the burden of STI testing in pregnancy, viewing prenatal care as a social and biological triad (pregnant woman, fetus and partner), where STI testing among both men and women would be a feasible strategy to improve women’s chances to have a normal birth.