Fathers need to be better informed about HIV prevention methods during breastfeeding (sub-Saharan Africa)

HIV breastfeeding

Recent research from sub-Saharan Africa has hinted at the difficulties created in HIV prevalent regions by the practice of confinement, whereby fathers are separated from their babies and partners. The researchers recommend better communication with fathers about the choice of HIV prevention methods.

The research records personal perspectives from focus group participants about what other people are considered to do, but nevertheless raises issues worthy of consideration.

The following claims were made in 23 focus groups (8 for mothers, 8 for fathers, 7 for grandmothers) and 36 interviews with service providers, organised in Malawi, South Africa, Uganda and Zimbabwe.

“When a woman has just given birth, she is weak, but some men do not give them those three months [without sex] to get healed.” [A father emphasising the importance of fathers supporting mothers’ recovery.]

“After wives have delivered, a lot of men like going out….They end up sleeping with prostitutes.” [A mother. This comment makes its way into the title of the research article.]

“When he goes out to look for other women, he gets infected with HIV and he goes to infect his wife back home.” [Female religious leader]

“In most cases, love ceases to exist [between a man and woman] when a woman gives birth. The woman diverts her love to the baby. The man may find it hard to endure the situation…So, if he commits adultery and in the process contracts HIV, he will infect the breastfeeding women.” [Father]

“Women when they do not keep themselves smart, like bathing regularly, they smell like milk and most men dislike that.” [Mother]

The researchers note, “Although there was a lot of discussion across groups about male partners’ infidelity during breastfeeding, participants agreed that not all male partners went in search of other partners during the breastfeeding period.” The positive role that fathers might play is not explored: the focus of the article is on what is wrong, not what is strong.

Pressure on reducing the period of confinement is reported. In common with the tone adopted by the researchers throughout the article, this is interpreted negatively, driven by women’s defence against men’s infidelity – “women in settings with high HIV prevalence have felt pressured to resume sex early to keep their male partners from seeking other partners”. The possibility of a more favourable explanation, that the pressure to reduce confinement may be driven by the father’s pain of separation from his wife and newborn child, is not considered but can be detected in the father’s responses. This hints at an issue that might usefully be explored in further research.

It was found that fathers were supportive of the use of female-initiated HIV prevention methods. They favoured open discussion with the mother about this, and expressed concerns about subterfuge and lack of trust in decision-making. Some fathers specified that they needed knowledge about the products on offer in order for good decisions to be possible.  63% of the women specified that fathers were the most influential person on their breastfeeding, compared with 19% saying that grandmothers were.

The researchers use the term “male partners” throughout their article, whereas in this report the terms “fathers” is used. It is the editorial policy of FamilyIncluded.com always to refer to parental status of fathers and not to use the term “male” when referring to people.


Flax VL et al (2020), After their wives have delivered, a lot of men like going out: Perceptions of HIV transmission risk and support for HIV prevention methods during breastfeeding in sub-Saharan Africa, Maternal & Child Nutrition

Header photo: The White Ribbon Alliance. Creative Commons.