Acceptability and strategies for enhancing uptake of human immunodeficiency virus self-testing in Nigeria.

BACKGROUND: In 2019, the Nigerian Ministry of Health published the first operational guidelines for human immunodeficiency virus self-testing (HIVST) to improve access to human immunodeficiency virus (HIV) testing services among undertested populations in the country. Also, as part of the campaign to increase HIV testing services in Nigeria, the Nigerian Ministry of Health developed standard operating procedures for using HIVST kits. AIM: To systematically review the acceptability and strategies for enhancing the uptake of HIVST in Nigeria. METHODS: The systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Different databases were searched to get the necessary materials needed for this review. Standardized forms developed by the authors were used for data extraction to minimize the risk of bias and ensure that the articles used for the study were properly screened. Identified articles were first screened using the titles and their abstracts. The full papers were screened, and the similarities of the documents were determined. Qualitative, quantitative, and mixed-method studies were evaluated using the Critical Appraisal Skills Programme and Critical Appraisal Framework criteria. RESULTS: All the publications reviewed were published between 2015 and 2022, with 33.3% published in 2021. Most (77.8%) of the studies were cross-sectional, 43.3% were conducted in Lagos State, and 26.3% were conducted among young people. The study revealed a high level of acceptability of HIVST. Certain factors, such as gender, sexual activity, and previous testing experience, influence the acceptability of HIV self-testing, with some individuals more likely to opt-out. The cost of the kit was reported as the strongest factor for choosing HIVST services, and this ranged from 200 to 4000 Naira (approximately United States Dollar 0.55-11.07), with the majority willing to pay 500 Naira (approximately United States Dollar 1.38). Privately-owned, registered pharmacies, youth-friendly centres, supermarkets, and online stores were the most cited access locations for HIVST. The least influential attribute was the type of specimen needed for HIVST. Strategies addressing cost and preferred access points and diverse needs for social media promotion, local translation of product use instructions, and HIVST distribution led by key opinion leaders for key populations were found to significantly enhance HIVST uptake and linkage to care. CONCLUSION: HIVST acceptability is generally high from an intention-to-use perspective. Targeted strategies are required to improve the acceptability of HIV self-testing, especially among males, sexually active individuals, and first-time testers. Identified and proposed uptake-enhancing strategies need to be investigated in controlled settings and among different populations and distribution models in Nigeria.

Stocking Practices of Anti-Tuberculosis Medications among Community Pharmacists and Patent Proprietary Medicine Vendors in Two States in Nigeria.

BACKGROUND: Evidence has shown that non-fixed-dose combination (non-FDC) anti-TB drugs could promote the spread of drug-resistant tuberculosis (DR-TB). We aimed to determine anti-TB medication stocking and dispensing practices among patent medicine vendors (PMVs) and community pharmacists (CPs) and their determinants. METHOD: This was a cross-sectional study using a structured, self-administered questionnaire among 405 retail outlets (322 PMVs and 83 CPs) across 16 Lagos and Kebbi local government areas (LGAs) between June 2020 and December 2020. Data were analyzed with Statistical Program for Social Sciences (SPSS) for Windows version 17 (IBM Corp., Armonk, NY, USA). Chi-square test and binary logistic regression were used to assess the determinants of anti-TB medication stocking practices at a p-value of 0.05 or less for statistical significance. RESULTS: Overall, 91%, 71%, 49%, 43% and 35% of the respondents reported stocking loose rifampicin, streptomycin, pyrazinamide, isoniazid and ethambutol tablets, respectively. From bivariate analysis, it was observed that being aware of directly observed therapy short course (DOTS) facilities (OR 0.48, CI 0.25-0.89, p < 0.019) and having previous training on TB (OR 0.32, CI 0.14-0.73, p < 0.005) reduced the odds of stocking anti-TB medication, while operating more than 1 shop (OR 3.32, CI 1.44-7.57, p = 0.004), having 3 or more apprentices (OR 5.31, CI 2.74-10.29, p < 0.001) and seeing over 20 clients/day (OR 3.02, CI 1.18-7.71, p = 0.017) increased the odds of stocking loose anti-TB medications. From multivariate analysis, it was observed that only the variable having three or more apprentices (OR 10.23, CI 0.10-0.49, p = 0.001) significantly increased the odds of stocking anti-TB medications. CONCLUSIONS: The stocking of non-FDC anti-TB medications was high and largely determined by the number of apprentices among PMVs and CPs in Nigeria, and this may have serious implications for drug resistance development. However, the results linking the stocking of anti-TB to the number of apprentices should be interpreted cautiously as this study did not control for the level of sales in the pharmacies. We recommend that all capacity-building and regulatory efforts for PMVs and CPs in Nigeria should include not just the owners of retail premises but also their apprentices.

Completion of 6-mo isoniazid preventive treatment among eligible under six children: A cross-sectional study, Lagos, Nigeria.

BACKGROUND: Nigeria is one of the thirty high burden countries with significant contribution to the global childhood tuberculosis epidemic. Tuberculosis annual risk for children could be as high as 4% particularly in high tuberculosis (TB) prevalent communities. Isoniazid (INH) Preventive Therapy has been shown to prevent TB incidence but data on its implementation among children are scarce. AIM: To determine the completion of INH among under six children that were exposed to adults with smear positive pulmonary TB in Lagos, Nigeria. METHODS: This was a hospital-based retrospective cross-sectional review of 265 medical records of eligible children < 6 years old enrolled for INH across 32 private hospitals in Lagos, Nigeria. The study took place between July and September 2020. Data was collected on independent variables (age, gender, type of facility, TB screening, dose and weight) and outcome variables (INH outcome and proportion lost to follow up across months 1-6 of INH treatment). RESULTS: About 53.8% of the participants were female, 95.4% were screened for TB and none was diagnosed of having TB. The participants' age ranged from 1 to 72 mo with a mean of 36.01 ± 19.67 mo, and 40.2% were between the ages of 1-24 mo. Only 155 (59.2%) of the 262 participants initiated on INH completed the six-month treatment. Cumulatively, 107 (41.0%) children were lost to follow-up at the end of the sixth month. Of the cumulative 107 loss to follow-up while on INH, largest drop-offs were reported at the end of month 2, 52 (49%) followed by 20 (19%), 17 (16%), 11 (10.2%) and 7 (6.5%) at months 3, 4, 5 and 6 respectively. The analysis showed that there was no significant association between age, gender, type of facility and completion of INH treatment (P > 0.005). CONCLUSION: This study demonstrated suboptimal INH completion rate among children with only 6 out of 10 children initiated on INH who completed a 6-mo treatment in Lagos, Nigeria. The huge drop-offs in the first 2 mo of INH calls for innovative strategies such as the use of 60-d INH calendar that would facilitate reminder and early engagement of children on INH and their caregivers in care and across the entire period of treatment.

Uncovering the Burden of Diabetes in Ekiti State, Nigeria: Insights From a Statewide, Household-Based, Cross-Sectional Study.

INTRODUCTION: Diabetes mellitus (DM) is an important global public health challenge, and the burden of the disease is huge, particularly in low- and middle-income countries (LMICs), where the majority of people with this condition reside. Undiagnosed DM is more prevalent in LMICs. The aim of this study is to determine the prevalence and associated factors for DM in Ekiti State. MATERIALS AND METHODS: A cross-sectional, household-based survey using a four-stage multistage sampling design and the World Health Organization (WHO)-STEPS survey manual was conducted from July to September 2020 as a part of the Ekiti State coronavirus disease 2019 (COVID-19) survey. Of the 5,145 sampled households, 4,726 individuals gave consent to participate in the survey. Out of these, 3043 had fasting plasma glucose results available and were included in the analysis. RESULTS: There were 2257 (74.2%) women and 786 (25.8%) men. The prevalence of DM was 6.5% (6.5% in males and 6.6% in females, P = 0.946). Diabetes was found to be more prevalent among those with a secondary school education or higher (10.9%); employed in the formal sector (13.4%); separated, divorced, or widowed (8.5%); with raised blood pressure (9.3%); and who were aged 30-59 years (all P < 0.05). Multivariable logistic regression showed that age, education, occupation, and hypertension were all positively and significantly associated with an increased risk of DM. CONCLUSION: The prevalence of DM in Ekiti State is high, and its predictors include advancing age, hypertension, education, and occupation. This calls for scaling up public health interventions for controlling DM, targeting the identified risk factors among the people of Ekiti.

Do private health providers adhere to National Tuberculosis Guideline while assigning treatment outcome? Findings from a lower middle-income country.

Background: Treatment success rate is an important indicator to measure the performance of the National Tuberculosis Program (NTP). There are concerns about the quality of outcome data from private facilities engaged by NTP. Adherence of private providers of tuberculosis care to NTP guideline while assigning treatment outcomes to patients is rarely investigated. We aimed to determine whether Lagos private for-profit (PFP) and private not-for-profit (PNFP) facilities adhere to domestic TB guideline while assigning treatment outcome and the availability of periodic sputum acid-fast bacilli (AFB) results. Method: A retrospective review of facility treatment register and treatment cards of TB patients managed between January and December 2016 across 10 private directly observed treatment short-course (DOTS) facilities involved in the public-private mix (PPM) in Lagos, Nigeria. The study took place between January and June 2019. Results: Of the 1,566 patients, majority (60.7%) were male, >30 years (50.2%), HIV-negative (88.4%), and attended PNFP (78.5%). The reported treatment success rate (TSR) was 84.2% while the actual TSR was 53.8%. In total, 91.1, 77.6, and 70.3% of patients had sputum acid-fast bacilli (AFB) at 2/3, month 5, and month 6, respectively, while 68.6% had all the three sputum AFB in the register. Healthcare workers (HCWs) were adherent in assigning treatment outcome for 65.6% of TB patients while 34.4% of patients were assigned incorrect treatment outcomes. Most variations between reported and actual treatment outcomes were found with cured (17%) and completed (13.4%). Successful and unsuccessful outcomes were overreported by 30.4% and 4.1%, respectively. DOTS providers in private facilities with available TB guideline (OR 8.33, CI 3.56-19.49, p < 0.0001) and PNFP facility (OR 4.42, CI 1.91-10.3, p = 0.001) were more likely to adhere to National TB Guideline while assigning TB treatment outcome. Conclusion: Frontline TB providers in Lagos private hospitals struggled with assigning correct treatment outcome for TB patients based on NTBLCP guideline. Increased access to all the periodic follow-up AFB tests for TB patients on treatment and availability of National TB Guideline for referencing could potentially improve the adherence of private TB service providers while assigning TB treatment outcomes.

Knowledge of International Standards for Tuberculosis Care among Private Non-NTP Providers in Lagos, Nigeria: A Cross-Sectional Study.

Studies specifically evaluating tuberculosis knowledge among private non-NTP providers using the International Standards for Tuberculosis Care (ISTC) framework are scarce. We evaluated the knowledge of ISTC among private non-NTP providers and associated factors in urban Lagos, Nigeria. We performed a cross-sectional descriptive study using a self-administered questionnaire to assess different aspects of tuberculosis management among 152 non-NTP providers in Lagos, Nigeria. The association between the dependent variable (knowledge) and independent variables (age, sex, qualifications, training and years of experience) was determined using multivariate logistic regression. Overall, the median knowledge score was 12 (52%, SD 3.8) and achieved by 47% of the participants. The highest knowledge score was in TB/HIV standards (67%) and the lowest was in the treatment standards (44%). On multivariate analysis, being female (OR 0.3, CI: 0.1−0.6, p < 0.0001) and being a nurse (OR 0.2, CI: 0.1−0.4, p < 0.0001) reduced the odds of having good TB knowledge score, while having previously managed ≥100 TB patients (OR 2.8, CI: 1.1−7.2, p = 0.028) increased the odds of having good TB knowledge. Gaps in the knowledge of ISTC among private non-NTP providers may result in substandard TB patient care. Specifically, gaps in knowledge of standard TB regimen combinations and Xpert MTB/RIF testing stood out. The present study provides evidence for tailored mentorship and TB education among nurses and female private non-NTP providers.

How Do Private Providers Unaffiliated With the Nigeria National TB Program Diagnose and Treat Drug-Susceptible TB Patients? A Cross-Sectional Study.

INTRODUCTION: TB diagnosis and treatment practices among private providers not affiliated with the Nigeria National TB Program (NTP) have implications for TB control efforts. Studies evaluating these practices among non-NTP providers are scarce. We aimed to investigate TB diagnosis and treatment practices among non-NTP private providers in urban Lagos State, Nigeria. METHODS: We conducted a cross-sectional study among doctors and nurses operating private facilities not formally affiliated with the NTP for TB case notification. Between May 2018 and January 2019, we implemented a survey using a pretested questionnaire among 152 doctors and nurses attending TB sensitization seminars in Lagos, Nigeria. We used descriptive statistics to summarize the sociodemographic information and proportion of non-NTP providers with different self-reported TB diagnostic, prescription, and monitoring practices. RESULTS: Private non-NTP doctors and nurses self-reported diagnosing TB using 8 different types of tests. Acid-fast bacilli was the most common (39.8%) means of diagnosing TB. Private non-NTP providers also self-reported prescribing 23 different TB regimens, including streptomycin, to treat TB. Only 32.4% of providers self-reported using the correct combinations of anti-TB drugs to treat TB. Additionally, 58.3% of providers prescribed the standard 6-month treatment duration for pulmonary TB patients, and the remaining 41.7% either undertreated or overtreated TB. CONCLUSION: A large proportion of private doctors and nurses not formally affiliated with the NTP in Nigeria were not following the NTP guidelines in the diagnosis and treatment of TB. Overtreatment and undertreatment were common. Engagement of these practitioners by the NTP in the form of supervision, on-the-job mentorship, and other strategies can mitigate the negative effects of their current practices on TB case notification and the spread of drug-resistant strains in Nigeria.

The Role of Laboratory Medicine in Addressing Migrant Health Problems.

INTRODUCTION: A migrant is a person who has relocated to another country for varying reasons. Laboratory medicine is a medical speciality in which body specimens are examined and results interpreted for the appropriate management of patients in healthy and diseased states. HEALTH CHALLENGES OF MIGRANTS: Migrants have health problems like the general population but may be affected by factors such as their geographic origin, living conditions, and their physical and psychological conditions. THE ROLE OF LABORATORY MEDICINE: Laboratory medicine will play a vital role in the provision of quality healthcare services to migrants. It will be actively involved in the screening, diagnosis, and monitoring of response to treatment. Effective public health surveillance among migrants will require laboratory services. The data gathered from research using laboratory resources will help in the improvement of the quality of migrant health.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks. FUNDING: Bill & Melinda Gates Foundation.

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BACKGROUND: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. METHODS: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. FINDINGS: We estimated that 6·3 million (95% UI 6·0-6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1-18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6-177·4) in Guinea-Bissau to 2·3 (1·8-2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. INTERPRETATION: Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. FUNDING: Bill & Melinda Gates Foundation, US Agency for International Development.

Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING: Bill & Melinda Gates Foundation.

Sexual Practices of Female Sex Workers Who Inject Drugs in Osogbo, Nigeria.

Female sex workers (FSWs) who inject drugs have higher risks of HIV infection due to injection drug use and the array of sexual practices employed. This study, therefore, is designed to determine sexual practices of FSWs who inject drug in Osogbo, Nigeria. This study was a cross-sectional descriptive mixed-methods design. Twenty-seven FSWs who inject drug were selected from 11 brothels by snowball sampling and interviewed with a semistructured questionnaire and in-depth interview guide. The mean age of respondents was 26.2 ± 7.5. Many of the respondents were aware of the magnitude of HIV and some were sex workers first before turning to be drug users. Some of the respondents had ever tested for HIV and few had ever been treated for STI more than once. Some respondents were willing to have male clients who do not wear a condom in exchange for accepting more money in return. Many of the respondents reported use of condom, regular talking of herbs, and good personal hygiene as ways of protecting themselves from HIV. Respondents have relatively high numbers of sexual partners. Involving sex workers directly in HIV prevention campaigns will encourage them to look after their health and to access services that could help them.

Married Men Perceptions and Barriers to Participation in the Prevention of Mother-to-Child HIV Transmission Care in Osogbo, Nigeria.

Men's role in HIV prevention is pivotal to changing the course of the epidemic. Men's barriers toward participation in Prevention of Mother-to-Child Transmission (PMTCT) have not been adequately documented. This study is therefore designed to determine men's level of awareness and barriers to their participation in PMTCT programmes in Osogbo, Nigeria. This study was a descriptive qualitative one that utilized Focus Group Discussion (FGD). One-hundred and sixty married men were selected by convenience sampling and interviewed. Data collected were analysed using content analysis technique. Demographic data were analysed using SPSS 15.0 software to generate frequency tables. Participants mean age was 31.9 ± 5.9 years. Many of the participants had heard about PMTCT and the majority agreed that it is good to accompany their wife to Antenatal Care (ANC) but only few had ever done so. Societal norms and cultural barriers were the leading identified barriers for male involvement in PMTCT programmes. The majority of the participant perceived it was a good idea to accompany their wife to antenatal care but putting this into practice was a problem due to societal norms and cultural barriers. Community sensitization programmes such as health education aimed at breaking cultural barriers should be instituted by government and nongovernmental agencies.