Abstract
BackgroundPregnant women living with HIV (WLH) face daily challenges maintaining their own and their babies' health and mental health. Standard Prevention of Maternal to Child Transmission (PMTCT) programs are not designed to address these challenges.Methods/DesignAs part of a cluster randomized controlled trial, WLH are invited to attend four antenatal and four postnatal small group sessions led by a peer WLH (a Peer Mentor). The WLH and their babies are assessed during pregnancy and at one week, six months, and twelve months post-birth. Mobile phones are used to collect routine information, complete questionnaires and remain in contact with participants over time. Pregnant WLH (N = 1200) are randomly assigned by clinic (N = 8 clinics) to an intervention program, called Masihambisane (n = 4 clinics, n = 600 WLH) or a standard care PMTCT control condition (n = 4 clinics; n = 600 WLH).DiscussionData collection with cellular phones are innovative and effective in low-resource settings. Standard PMTCT programs are not designed to address the daily challenges faced by WLH; Peer Mentors may be useful in supporting WLH to cope with these challenges.Trial registrationClinicalTrials.gov registration # NCT00972699
Highlights
Pregnant women living with HIV (WLH) face daily challenges maintaining their own and their babies’ health and mental health
Standard Prevention of Maternal to Child Transmission (PMTCT) programs are not designed to address the daily challenges faced by WLH; Peer Mentors may be useful in supporting WLH to cope with these challenges
Masihambisane is a cluster randomized controlled trial (RCT) to test the effectiveness of Peer Mentor support in addressing health, mental health, and stigma challenges faced by WLH
Summary
An estimated 1.4 million pregnant women are women living with HIV (WLH) in low and middle income countries (LMIC) [1]. Effective programs to prevent mother-to-child transmission (PMTCT) for WLH in South Africa are urgently needed. The goal of this cluster randomized controlled trial (RCT) is to evaluate a clinic-based strategy for increasing uptake of PMTCT and to improve maternal health behaviors over time. Most South Africans consider more than one antenatal care visit unnecessary [30], WLH are unlikely to receive the information, skills, and support needed to consistently maintain healthy routines for themselves or for their child. The Masihambisane Project, which means “we walk together” in Zulu, was initiated to test the effectiveness of a Peer Mentor programme in improving the health and well-being of WLH and their babies in PMTCT services provided by the public sector [35] in a very high seroprevalence area
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