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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Pregnant women living with HIV (WLH) supported at clinics by peer WLH: A cluster randomized controlled trial
AIDS and Behavior, Volume 18, No. 4, Year 2014
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Description
Throughout Africa, Peer Mentors who are women living with HIV (WLH) are supporting pregnant WLH at antenatal and primary healthcare clinics (McColl in BMJ 344:e1590, 2012). We evaluate a program using this intervention strategy at 1.5 months post-birth. In a cluster randomized controlled trial in KwaZulu-Natal, South Africa, eight clinics were randomized for their WLH to receive either: standard care (SC), based on national guidelines to prevent mother-to-child transmission (4 clinics; n = 656 WLH); or an enhanced intervention (EI; 4 clinics; n = 544 WLH). The EI consisted of four antenatal and four postnatal small group sessions led by Peer Mentors, in addition to SC. WLH were recruited during pregnancy and 70 % were reassessed at 1.5 months post-birth. EI's effect was ascertained on 16 measures of maternal and infant well-being using random effects regressions to control for clinic clustering. A binomial test for correlated outcomes evaluated EI's overall effectiveness. Among EI WLH reassessed, 87 % attended at least one intervention session (mean 4.1, SD 2.0). Significant overall benefits were found in EI compared to SC using the binomial test. However, it is important to note that EI WLH were significantly less likely to adhere to ARV during pregnancy compared to SC. Secondarily, compared to SC, EI WLH were more likely to ask partners to test for HIV, better protected their infants from HIV transmission, and were less likely to have depressed mood and stunted infants. Adherence to clinic intervention groups was low, yet, there were benefits for maternal and infant health at 1.5 months post-birth. © 2014 Springer Science+Business Media New York.
Authors & Co-Authors
Richter, Linda M.
South Africa, Pretoria
Human Sciences Research Council of South Africa
South Africa, Johannesburg
University of the Witwatersrand
Rotheram-Borus, Mary Jane Ane
United States, Los Angeles
University of California, Los Angeles
van Heerden, Alastair C.
South Africa, Pretoria
Human Sciences Research Council of South Africa
Stein, Alan L.
South Africa, Pretoria
Human Sciences Research Council of South Africa
United Kingdom, Oxford
University of Oxford
Mark Tomlinson, Mark
South Africa, Stellenbosch
Stellenbosch University
Harwood, Jessica M.
United States, Los Angeles
University of California, Los Angeles
Rochat, Tamsen Jean
South Africa, Durban
Africa Health Research Institute
Van-Rooyen, Heidi E.
South Africa, Pretoria
Human Sciences Research Council of South Africa
Comulada, Warren Scott
United States, Los Angeles
University of California, Los Angeles
Tang, Zihling
United States, Los Angeles
University of California, Los Angeles
Statistics
Citations: 85
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1007/s10461-014-0694-2
ISSN:
10907165
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female