Attitudes towards male partner HIV testing among low-income, minority pregnant women and their partners

•Little is known about attitudes about partner HIV testing in prenatal care.•Attitudes about risk and testing history influenced partner testing decisions.•Logistical considerations of HIV testing influenced partner testing preferences.•Pregnant women were motivators for male engagement in testing and healthcare.•Partner HIV testing programs must engage pregnant women and their partners. Primary prevention of maternal HIV seroconversion requires knowledge of the HIV status of sexual partners, but testing rates, particularly among urban minority heterosexual males, remain low. This study was initiated to understand the attitudes of pregnant women and their partners surrounding partner HIV testing. This was a qualitative study of pregnant women receiving publicly-funded prenatal care in a large urban hospital located in a high HIV prevalence area and their partners. Participants underwent in-depth individual interviews about HIV testing. Semi-structured interview guides were used to elicit participant attitudes. Transcripts were analyzed using the constant comparative method to determine themes and subthemes; analysis was organized by whether participants desired or declined partner testing. Of 51 participants, 29 were pregnant women and 22 were male partners of female participants. Reasons for desiring or declining HIV testing aligned within three major themes: risk perception, logistical considerations, and testing history. An individual’s perception of risk included evaluations of fetal safety as well as partner autonomy and fidelity. Logistical considerations included cost, test availability, and male partner geographic location. Individuals’ recent testing histories also influenced testing preferences. One cross-cutting theme was of the pregnant woman taking responsibility for family health, which could serve as a motivator to test or reason to decline. Pregnant women are often the linchpin of prevention of HIV transmission in the family unit. These data inform strategies to engage pregnant women and their partners to improve implementation of partner HIV testing in the prenatal setting.