The effect of an interactive weekly mobile phone messaging on retention in prevention of mother to child transmission (PMTCT) of HIV program: study protocol for a randomized controlled trial (WELTEL PMTCT)

Awiti, Patricia Opondo; Grotta, Alessandra; Kop, Mia van der; Dusabe, John; Thorson, Anna; Mwangi, JW; Belloco, Rino; Lester, Richard; Ternent, Laura; Were, Edwin; Ekström, Anna Mia

doi:10.1186/s12911-016-0321-4

Cited by 27 publications

(31 citation statements)

References 13 publications

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“…This is a cross-sectional study of pregnant women living with HIV and enrolled in the WelTel PMTCT trial from June 2015 to July 2016. The WelTel PMTCT trial is a multicentre randomised controlled trial designed to test the efficacy of weekly interactive mobile text messages for improving retention in PMTCT care among women and infants in western Kenya [28]. Pregnant women living with HIV, 18 years or older, consecutively presenting for their first antenatal care (ANC) visit in their current pregnancy were informed about the WelTel PMTCT trial by a trained local research assistant at their clinic.…”

Section: Study Design Population and Locationmentioning

confidence: 99%

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

Nordberg

Gabriel

Were

et al. 2020

BMC Pregnancy Childbirth

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Background: Social concerns about unintentional HIV status disclosure and HIV-related stigma are barriers to pregnant women's access to prevention of mother-to-child transmission of HIV (PMTCT) care. There is limited quantitative evidence of women's social and emotional barriers to PMTCT care and HIV disclosure. We aimed to investigate how social concerns related to participation in PMTCT care are associated with HIV status disclosure to partners and relatives among pregnant women living with HIV in western Kenya. Methods: A cross-sectional study, including 437 pregnant women living with HIV, was carried out at enrolment in a multicentre mobile phone intervention trial (WelTel PMTCT) in western Kenya. Women diagnosed with HIV on the day of enrolment were excluded. To investigate social concerns and their association with HIV disclosure we used multivariableadjusted logistic regression, adjusted for sociodemographic and HIV-related characteristics, to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: The majority (80%) had disclosed their HIV status to a current partner and 46% to a relative. Older women (35-44 years) had lower odds of disclosure to a partner (OR = 0.15; 95% CI: 0.05-0.44) compared to women 18-24 years. The most common social concern was involuntary HIV status disclosure (reported by 21%). Concern about isolation or lack of support from family or friends was reported by 9%, and was associated with lower odds of disclosure to partners (OR = 0.33; 95% CI: 0.12-0.85) and relatives (OR = 0.37; 95% CI: 0.16-0.85). Concern about separation (reported by 5%; OR = 0.17; 95% CI: 0.05-0.57), and concern about conflict with a partner (reported by 5%; OR = 0.18; 95% CI: 0.05-0.67), was associated with lower odds of disclosure to a partner.

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Section: Study Design Population and Locationmentioning

confidence: 99%

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

Nordberg

Gabriel

Were

et al. 2020

BMC Pregnancy Childbirth

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“…In this study, participants will receive an interactive weekly SMS and based on the response by the participant, a PMTCT nurse will be prompted to follow-up on any indications of problems. The primary outcome will be infant retention in care by quantifying the number of infants testing for HIV at 24 months from delivery (Awiti et al, 2016). The most recent protocol is a randomized pilot trial, taking place in South Africa, which evaluates the feasibility of a conducting a larger pilot study that will assess the effectiveness of an interactive weekly text message plus motivational interviews to improve adherence to breastfeeding by HIV-infected women.…”

Section: Ongoing Studiesmentioning

confidence: 99%

Smartphone usage and preferences among postpartum HIV-positive women in South Africa

et al. 2018

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Departmental and ethical approval Literature review Data analysis Manuscript write up Dissertation submission Western Cape Government. (2014). New project connects expectant moms to government health services. World Health Organization (WHO). (2012). Use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants executive summary. Retrieved from http://www.who.int/hiv/PMTCT_update.pdf

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“…In addition, studies addressing structural factors showed promising results with integration of postpartum care into routine care for the child or family [66] [67], mHealth reminders and cash transfers [68][69][70][71][72]. Ongoing studies will evaluate effects of mHealth strategies [73,74], reaching women with mental health challenges in pregnancy and postpartum [75,76] and adherence clubs/decentralized care [77]. Women in different contexts will require different types of support [78,79] and an adaptive trial design [80] may be an efficient way to evaluate strategies to combine intervention elements to support women to remain in care [81].…”

Section: Discussionmentioning

confidence: 99%

Adherence to HIV antiretroviral therapy among pregnant and postpartum women during the Option B+ era: 12‐month cohort study in urban South Africa and rural Uganda

et al. 2020

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Introduction We conducted a cohort study to understand patterns of anti‐retroviral therapy (ART) adherence during pregnancy, postpartum and non‐pregnancy follow‐up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. Methods We collected survey data, continuously monitored ART adherence (Wisepill), HIV‐RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow‐up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non‐pregnancy‐related (neither pregnant nor postpartum). Fractional regression models included demographics and socio‐behavioural factors informed by the Behavioral Model for Vulnerable Populations. We evaluated HIV‐RNA at 12 months by ever‐ versus never‐pregnant status. Results In Uganda, 247 women contributed 676, 900 and 1274 months of pregnancy, postpartum and non‐pregnancy‐related follow‐up. Median ART adherence was consistently ≥90%: pregnancy, 94% (interquartile range [IQR] 78,98); postpartum, 90% (IQR 70,97) and non‐pregnancy, 90% (IQR 80,98). Poorer adherence was associated with younger age (0.98% [95% CI 0.33%, 1.62%] average increase per year of age) and higher CD4 cell count (1.01% [0.08%, 1.94%] average decrease per 50 cells/mm3). HIV‐RNA was suppressed among 91% (N = 135) ever‐pregnant and 86% (N = 85) never‐pregnant women. In South Africa, 190 women contributed 259, 624 and 1247 months of pregnancy, postpartum and non‐pregnancy‐related follow‐up. Median adherence was low during pregnancy, 74% (IQR 31,96); postpartum, 40% (IQR 4,65) and non‐pregnancy, 77% (IQR 47,92). Poorer adherence was associated with postpartum status (22.3% [95%CI 8.6%, 35.4%] average decrease compared to non‐pregnancy‐related follow‐up) and less emotional support (1.4% [0.22%, 2.58%] average increase per unit increase). HIV‐RNA was suppressed among 57% (N = 47) ever‐pregnant and 86% (N = 93) never‐pregnant women. Conclusions Women in rural Uganda maintained high adherence with 91% of ever‐pregnant and 86% of never‐pregnant women suppressing HIV‐RNA at 12 months. Women in urban South Africa struggled with adherence, particularly during postpartum follow‐up with median adherence of 40% and 57% of women with HIV‐RNA suppression at one year, suggesting a crisis for postpartum women with HIV in South Africa. Findings suggest that effective interventions should promote emotional support.

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The effect of an interactive weekly mobile phone messaging on retention in prevention of mother to child transmission (PMTCT) of HIV program: study protocol for a randomized controlled trial (WELTEL PMTCT)

Cited by 27 publications

References 13 publications

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

Smartphone usage and preferences among postpartum HIV-positive women in South Africa

Adherence to HIV antiretroviral therapy among pregnant and postpartum women during the Option B+ era: 12‐month cohort study in urban South Africa and rural Uganda

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