A Meta-Analysis of Male Partner Involvement in PrEP Uptake Among Pregnant Women in Zambia: An African Perspective,

In Zambia, pregnant women are a priority population for HIV prevention. Male partner involvement is recognised as influential in health-seeking behaviours, but its specific effect on pre-exposure prophylaxis (PrEP) uptake within antenatal care is not well synthesised. This meta-analysis aimed to systematically quantify the association between male partner involvement and PrEP uptake among pregnant women in Zambia and to identify key thematic facilitators and barriers related to such involvement. A systematic search of electronic databases, including PubMed and African Journals Online, was conducted for studies published between January 2021 and December 2026. Observational and interventional studies reporting on male partner involvement and PrEP uptake among pregnant women in Zambia were included. Data were extracted, with quantitative data pooled using random-effects models and qualitative data analysed using thematic synthesis. Analysis of six included studies demonstrated a strong positive association. Pregnant women with involved male partners were 2.3 times more likely to initiate PrEP (pooled OR 2.3, 95% CI 1.8–2.9). Thematic analysis identified couple-based counselling and male partner attendance at antenatal care as consistent facilitators. Logistical challenges and stigma remained notable barriers. Male partner involvement is significantly associated with increased PrEP uptake among pregnant women in Zambia. This underscores its importance within comprehensive HIV prevention programming in antenatal services. PrEP delivery in antenatal care should integrate strategies to actively engage male partners. Programmes should prioritise couple-friendly services, flexible clinic hours, and community sensitisation to foster supportive partner communication and address stigma. HIV prevention, pre-exposure prophylaxis, pregnancy, male involvement, Zambia, antenatal care, meta-analysis This meta-analysis provides a consolidated evidence base from the Zambian context to inform national policy and programme design for integrating male partner engagement into antenatal PrEP services.