Background: HIV testing of partners of pregnant and breastfeeding women is essential for PMTCT and the prevention of intra-couple transmission, yet male involvement in Cameroon remains insufficient, undermining prevention efforts.
Objective: To assess the acceptability of HIV testing, estimate HIV prevalence, and identify associated factors among partners of pregnant and breastfeeding women in Cameroon.
Methods: A cross-sectional household survey was conducted from 5 May to 30 June 2025 in 63 health districts across six regions of Cameroon. Spouses of pregnant and breastfeeding women were voluntarily recruited at the household level. HIV testing followed the national algorithm using two rapid tests (Determine and Shanghai), with community-based double testing and facility confirmation prior to referral for care.
Results: A total of 1,639 spouses of pregnant or breastfeeding women were included, predominantly from the Far North (32.1%), with a mean age of 36.7 ± 7.8 years. Overall, 69.5% accepted HIV testing. Acceptability was lower among partners in the West (aPR = 0.55; p < 0.001) and South (aPR = 0.80; p = 0.002), urban residents (aPR = 0.90; p = 0.004), those living more than 5 km from a health facility (aPR = 0.89; p = 0.005), and agricultural workers (aPR = 0.79; p < 0.001), but higher among spouses of women tested during pregnancy (aPR = 1.31; p = 0.020) and those with HIV-positive partners (aPR = 1.30; p < 0.001). HIV prevalence was 2.02% (95% CI: 1.35–3.01), higher among cohabiting spouses (aPR = 1.85; p = 0.014) and lower among those engaged in income-generating activities (aPR = 0.07; p < 0.001) and urban residents (aPR = 0.61; p = 0.026).
Conclusion: Low HIV testing acceptability among partners of pregnant and breastfeeding women in Cameroon underscores the need for strengthened male involvement and targeted community strategies to improve PMTCT and reduce intra-couple transmission.