Why do Integrated Maternal HIV and Infant Healthcare Services work? A Secondary Analysis of a Randomised Controlled Trial in South Africa
Bibliographic Data
| ID | 15333761 |
|---|---|
| Authors | Kirsty Brittain (0000-0003-3940-1242, University of Cape Town, corresponding author), Karryn Brown (0000-0002-6132-4717, University of Cape Town), Tamsin K Phillips (0000-0003-4554-2922, University of Cape Town), Tamsin Phillips, Allison Zerbe (0000-0002-3372-6882, Columbia University), Jennifer A Pellowski (0000-0003-3316-4135, Brown University), Robert H Remien (0000-0002-3963-3273, New York Psychoanalytic Society and Institute), Claude Ann Mellins (0000-0002-1978-7638, New York Psychoanalytic Society and Institute), Elaine J Abrams (0000-0001-7938-8981, Columbia University), Landon Myers (0000-0002-8106-7658, University of Cape Town) |
| Year | 2023 |
| Volume | 27 |
| Issue | 12 |
| Pages | 3831-3843 |
| Publication date | 2023-06-12 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | AIDS and Behavior (JOURNAL) |
| Journal identifiers | ISSN: 1090-7165 • E-ISSN: 1573-3254 |
| Publisher | Springer Science+Business Media (PUBLISHER • DE) |
| DOI | 10.1007/s10461-023-04097-x |
| PMID | 37306847 |
| OpenAlex | W4380291848 |
| Language | EN |
| References cited | 72 |
In a randomised trial, we found that integrated maternal HIV and infant health services through the end of breastfeeding were significantly associated with the primary outcome of engagement in HIV care and viral suppression at 12 months postpartum, compared to the standard of care. Here, we quantitatively explore potential psychosocial modifiers and mediators of this association. Our findings suggest that the intervention was significantly more effective among women experiencing an unintended pregnancy but did not improve outcomes among women reporting risky alcohol use. Although not statistically significant, our results suggest that the intervention may also be more effective among women experiencing higher levels of poverty and HIV-related stigma. We observed no definitive mediator of the intervention effect, but women allocated to integrated services reported better relationships with their healthcare providers through 12 months postpartum. These findings point to high-risk groups that may benefit the most from integrated care, as well as groups for whom these benefits are hampered and that warrant further attention in intervention development and evaluation
Breastfeeding · Environmental health · Family medicine · Health care · Health psychology · Intervention (counseling · Postnatal Care · Poverty · Pregnancy · Psychiatry · Psychosocial · Public health · Randomized controlled trial · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Nursing · Pediatrics
Barriers and facilitating factors to the uptake of antiretroviral drugs for prevention of mother‐to‐child transmission of HIV in sub‐Saharan Africa
The Association of HIV-Related Stigma to HIV Medication Adherence
Adherence to antiretroviral therapy during and after pregnancy in low-income, middle-income, and high-income countries
Structural Equation Modeling
Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa
The beliefs about medicines questionnaire
The ASA Statement on p -Values
Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors
Violence Against Women
A Systematic Review of Individual and Contextual Factors Affecting ART Initiation, Adherence, and Retention for HIV-Infected Pregnant and Postpartum Women
Two Brief Alcohol-Screening Tests From the Alcohol Use Disorders Identification Test (Audit)
HIV testing attitudes, Aids stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa
Impact of HIV‐related stigma on treatment adherence
Detection of Postnatal Depression
The Audit Alcohol Consumption Questions (Audit-C) An Effective Brief Screening Test for Problem Drinking
Short screening scales to monitor population prevalences and trends in non-specific psychological distress
Self-reported adherence to antiretroviral medications among participants in HIV clinical trials
Theory development for HIV behavioral health
Correlates of adherence to combination antiretroviral therapy among members of HIV-positive mixed status couples
“You must leave but I didn’t want to leave”
Common mental health problems and antiretroviral therapy adherence
Determinants of suboptimal adherence and elevated HIV viral load in pregnant women already on antiretroviral therapy when entering antenatal care in Cape Town, South Africa
Development of a measure of the patient–provider relationship in antenatal care and its importance in PMTCT
Correlates of HIV antiretroviral adherence in persons with serious mental illness
Adherence to antiretroviral treatment among pregnant and postpartum HIV-infected women
The Measurement and Meaning of Unintended Pregnancy
Prevalence and Factors Associated with Fixed-Dose Combination Antiretroviral Drugs Adherence among HIV-Positive Pregnant Women on Option B Treatment in Mpumalanga Province, South Africa
Outcomes of Implementing in the Real World the Women's Health CoOp Intervention in Cape Town, South Africa
Personal HIV Knowledge, Appointment Adherence and HIV Outcomes
Alcohol, But Not Depression or IPV, Reduces HIV Adherence Among South African Mothers Living with HIV Over 5 Years
Social Support, Stigma and Antenatal Depression Among HIV-Infected Pregnant Women in South Africa
Self-Reported Long-Term Antiretroviral Adherence
Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years
The Effects of Unintended Pregnancy on Infant, Child, and Parental Health
The Dimensionality of Stigma
| Citation velocity | historical |
|---|---|
| Highly cited | No |