Impact of Facility- and Community-Based Peer Support Models on Maternal Uptake and Retention in Malawi's Option B+ HIV Prevention of Mother-to-Child Transmission Program: A 3-Arm Cluster Randomized Controlled Trial (PURE Malawi)

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Sam PhiriPURE Malawi Consortium

Abstract

Many sub-Saharan African countries have adopted Option B+, a prevention of mother-to-child transmission approach providing HIV-infected pregnant and lactating women with immediate lifelong antiretroviral therapy. High maternal attrition has been observed in Option B+. Peer-based support may improve retention. A 3-arm stratified cluster randomized controlled trial was conducted in Malawi to assess whether facility- and community-based peer support would improve Option B+ uptake and retention compared with standard of care (SOC). In SOC, no enhancements were made (control). In facility-based and community-based models, peers provided patient education, support groups, and patient tracing. Uptake was defined as attending a second scheduled follow-up visit. Retention was defined as being alive and in-care at 2 years without defaulting. Attrition was defined as death, default, or stopping antiretroviral therapy. Generalized estimating equations were used to estimate risk differences (RDs) in uptake. Cox proportional hazards regression with shared frailties was used to estimate hazard of attrition. Twenty-one facilities were randomized and enrolled 1269 women: 447, 428, and 394 in facilities that implemented SOC, facility-based, and ...Continue Reading

Associated Clinical Trials

Dec 9, 2013·Sam Phiri, PhD, MSc, DCM

References

Nov 19, 2010·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Tom DecrooNathan Ford
Jul 20, 2011·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team
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Citations

Jul 29, 2017·International Journal of STD & AIDS·Blake M HauserNora E Rosenberg
May 21, 2018·Tropical Medicine & International Health : TM & IH·Marie Marcelle DeschampsMargaret L McNairy
Nov 30, 2019·African Journal of AIDS Research : AJAR·Steven ForsytheSara Bowsky
May 13, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Nigel C RollinsGottfried O Hirnschall
Dec 30, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Brandon A KnettelMelissa H Watt
Aug 21, 2020·Journal of the International AIDS Society·Benjamin H ChiChewe Luo
Aug 11, 2020·Current HIV/AIDS Reports·Rebecca JoplingMelanie Amna Abas
May 13, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Mina HosseinipourUNKNOWN PURE Malawi Consortium
Oct 9, 2020·Journal of the International AIDS Society·Helene FontUNKNOWN INSPIRE group
Apr 29, 2021·The Journal of the Association of Nurses in AIDS Care : JANAC·Brandon A KnettelMichael V Relf

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