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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A cluster randomized controlled trial evaluating the efficacy of peer mentors to support South African women living with HIV and their infants
PLoS ONE, Volume 9, No. 1, Article e84867, Year 2014
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Description
Objective: We evaluate the effect of clinic-based support by HIV-positive Peer Mentors, in addition to standard clinic care, on maternal and infant well-being among Women Living with HIV (WLH) from pregnancy through the infant's first year of life. Methods: In a cluster randomized controlled trial in KwaZulu-Natal, South Africa, eight clinics were randomized for pregnant WLH to receive either: a Standard Care condition (SC; 4 clinics; n = 656 WLH); or an Enhanced Intervention (EI; 4 clinics; n = 544 WLH). WLH in the EI were invited to attend four antenatal and four postnatal meetings led by HIV-positive Peer Mentors, in addition to SC. WLH were recruited during pregnancy, and at least two post-birth assessment interviews were completed by 57% of WLH at 1.5, 6 or 12 months. EI's effect was ascertained on 19 measures of maternal and infant wellbeing using random effects regressions to control for clinic clustering. A binomial test for correlated outcomes evaluated EI's overall efficacy. Findings: WLH attended an average of 4.1 sessions (SD = 2.0); 13% did not attend any sessions. Significant overall benefits were found in EI compared to SC using the binomial test. Secondarily, over time, WLH in the EI reported significantly fewer depressive symptoms and fewer underweight infants than WLH in the SC condition. EI WLH were significantly more likely to use one feeding method for six months and exclusively breastfeed their infants for at least 6 months. Conclusions: WLH benefit by support from HIV-positive Peer Mentors, even though EI participation was partial, with incomplete follow-up rates from 6-12 months. Trial Registration: ClinicalTrials.gov NCT00972699 © 2014 Rotheram-Borus et al.
Authors & Co-Authors
Rotheram-Borus, Mary Jane Ane
United States, Los Angeles
University of California, Los Angeles
Richter, Linda M.
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Pretoria
Human Sciences Research Council of South Africa
van Heerden, Alastair C.
South Africa, Johannesburg
University of the Witwatersrand
Van-Rooyen, Heidi E.
South Africa, Johannesburg
University of the Witwatersrand
Mark Tomlinson, Mark
South Africa, Stellenbosch
Stellenbosch University
Harwood, Jessica M.
United States, Los Angeles
University of California, Los Angeles
Comulada, Warren Scott
United States, Los Angeles
University of California, Los Angeles
Stein, Alan L.
United Kingdom, Oxford
University of Oxford
Statistics
Citations: 81
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0084867
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female