Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV

Rotheram-Borus, M. J.; Richter, Linda; Rooyen, Heidi van; Heerden, Alastair van; Tomlinson, Mark; Stein, Alan; Rochat, Tamsen; Kadt, Julia de; Mtungwa, Nonhle; Mkhize, Lungile; Ndlovu, Lindo; Ntombela, Lungile; Comulada, W. Scott; Desmond, Katherine A.; Greco, Erin

doi:10.1186/1745-6215-12-2

Cited by 69 publications

(62 citation statements)

References 30 publications

(34 reference statements)

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“…Mofeson, Couvadia, & Bryant), a local Community Advisory Board, and the Research Ethics Committee of the Human Sciences Research Council in South Africa (HSRC, REC 4/07/03/07) approved all study protocols [21]. The trial is registered at ClinicalTrials.gov # NCT00972699.…”

Section: Methodsmentioning

confidence: 99%

“…We adapted the M2M program [21] based on a pilot study in Cape Town [26] and 6 months of piloting an adapted M2M program in KZN [21]. An eight-session intervention (four antenatal sessions, four postnatal sessions) was designed to support WLH through pregnancy and early motherhood.…”

Section: Methodsmentioning

confidence: 99%

“…We hypothesized that, compared to WLH receiving standard clinic care (the Standard Care (SC) condition), WLH at clinics in the EI condition would have improved maternal and infant well-being in the following domains: (1) prevention of HIV transmission to partners and infants; (2) infant health; (3) healthcare and health monitoring; (4) mental health; and (5) parenting tasks to ensure entitlements, including registering the child's birth and securing the child support grant. Given that we are examining outcomes in five domains, with multiple markers per domain, we utilized a binomial test for correlated outcomes as the primary evaluation measure after conducting a series of regression analyses [21]. At about 1.5 months, EI sessions were expected to be complete, and the follow-up assessment was a post-intervention analysis.…”

Section: Introductionmentioning

confidence: 99%

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Pregnant Women Living with HIV (WLH) Supported at Clinics by Peer WLH: A Cluster Randomized Controlled Trial

et al. 2014

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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.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pregnant Women Living with HIV (WLH) Supported at Clinics by Peer WLH: A Cluster Randomized Controlled Trial

et al. 2014

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“…By addressing the administrative burden of reporting indicators, Rwanda has been able to identify areas of the ART delivery program that are successful and where it may need to be strengthened [21]. In South Africa, a cluster randomized controlled trial evaluating an m-health peer-facilitated support group for PMTCT was able to utilize mhealth to successfully collect routine information, complete questionnaires, and remain in contact with participants over time [22]. In another example, a study evaluating safety and adherence to pre-exposure prophylaxis among men who have sex with men and female sex workers in Kenya sent daily SMS to participants to collect data on sexual activity [23].…”

Section: Health System-focused M-healthmentioning

confidence: 97%

Mobile health applications for HIV prevention and care in Africa

Forrest

Wiens

Kanters

et al. 2015

Current Opinion in HIV and AIDS

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The potential for m-health in Africa is numerous and should not be limited only to direct patient-care focused applications. Although the use of smart phone technology is on the rise in Africa, text messaging remains the primary mode of delivering m-health interventions. The rate at which mobile phone technologies are being adopted may outpace the rate of evaluation. Other methods of evaluation should be considered beyond only randomized-controlled trials.

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“…A recent review highlighted that psychiatric symptoms, particularly depression, and mental health vulnerabilities are widespread among HIV-infected women globally and have a potential to affect psychological well-being, quality of live and salient clinical outcomes (Kapetanovic 2014).Then, receiving a positive HIV diagnosis during pregnancy often elicits feelings of anxiety, depression and social isolation (Rochat 2006; Rotheram-Borus 2011). Poor mental health and a lack of social support are, in turn, associated with decreased adherence to ARV medication, and faster disease progression (Starace 2002;Cook 2006;Rotheram-Borus 2011). Also, to decrease social support and mental health, WLH face other challenges such as fears of transmitting the infection to their baby and Impact on ability to raise children (Faithfull 1997).…”

Section: Description Of the Conditionmentioning

confidence: 99%

Mobile Phone Communication for Improving Uptake of Antiretroviral Therapy in HIV-infected Pregnant Women: Review

Tamuzi¹,

Okwundu²

2017

IAM

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Background: About 1.4 million pregnant women are living with HIV in low and middle-income countries with about 91% of these women residing in sub-Saharan Africa. HIV-infected pregnant women face several challenges that could decrease antiretroviral therapy adherence. Studies reported challenges such as poor mental health, lack of social support, fears of infecting children, medication side effects, cultural factors, economic instability, nausea and vomiting during pregnancy. This review investigated whether mobile phone text messaging could improve antiretroviral therapy in during and after pregnancy. Objectives : To assess the effectiveness mobile phone text messaging for improving adherence to antiretroviral therapy in HIV-infected pregnant women. To investigate whether mobile phone text messaging could improve follow-up in HIV-exposed infants. Search methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, MEDLINE via PubMed, Web of Science, CINAHL (EBSCO). Furthermore, we searched studies through HIV/AIDS conferences websites: International AIDS conferences, The European AIDS Clinical Society (EACS) conferences, International AIDS Society Conference on HIV Pathogenesis and Treatment (IAS). Two authors extracted data in the study eligibility form. Selection criteria: We selected randomized controlled trials (RCTs) assessing mobile phone text messaging as reminders for antiretroviral therapy uptake in HIV-infected pregnant women. Data collection and analysis: Two authors independently identified and assessed all studies that met inclusion criteria. Study design, characteristics of study populations, interventions and controls and study results were extracted by two review authors. Also, the risk of bias of included studies was assessed independently by two reviewers. We reported the results narratively as meta-analysis was not feasible because of differences in the study design. We reported the odds ratio with 95% confidence intervals for the different outcomes. Main results: We identified five eligible studies; three ongoing and two completed studies. Findings from the included studies showed that mobile phone text messaging did not increase antiretroviral therapy initiation (OR 1.79 95%CI 1.09 to 2.94, 307 participants, 1 study). However, there was an increase in maternal clinic attendance and HIV tested infants; (RR 1.66 95%CI 1.02 to 2.70, 381 participants, 1 study) and (OR 2.01 95%CI 1.03 to 3.92, 325 participants, 1 study), respectively. The overall quality of evidence was assessed as moderate. None of the included studies reported on adherence to antiretroviral therapy. Authors' Conclusions: The review revealed that mobile phone text messaging may improve maternal clinic attendance and number infants tested for HIV compared to the standard care. Mobile phone communication did not improve ART initiation compared to standard care. Further studies are needed to evaluate the value of mobile phone communication in promoting adherence to antiretroviral drugs among pregnan...

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Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV

Cited by 69 publications

References 30 publications

Pregnant Women Living with HIV (WLH) Supported at Clinics by Peer WLH: A Cluster Randomized Controlled Trial

Pregnant Women Living with HIV (WLH) Supported at Clinics by Peer WLH: A Cluster Randomized Controlled Trial

Mobile health applications for HIV prevention and care in Africa

Mobile Phone Communication for Improving Uptake of Antiretroviral Therapy in HIV-infected Pregnant Women: Review

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