Peer Support to Mitigate the Impact of Stigma in Young HIV+ Pregnant & Postpartum Women
- Conditions
- Hiv
- Interventions
- Behavioral: Peer support intervention
- Registration Number
- NCT04036851
- Lead Sponsor
- University of Cape Town
- Brief Summary
Young pregnant and postpartum women living with HIV are at the greatest risk of disengagement from HIV services and suboptimal adherence to antiretroviral therapy (ART). Among young women, stigma is a major barrier to retention in services and adherence to ART, and interventions are needed to combat stigma and improve ART outcomes. The investigators are conducting a pilot study of a peer support intervention to mitigate the negative effects of stigma in this population.
- Detailed Description
Despite major reductions in mother-to-child HIV transmission (MTCT), young pregnant and postpartum women living with HIV remain a vulnerable group and experience the greatest risk of disengagement from services and suboptimal adherence to antiretroviral therapy (ART). HIV-related and intersectional stigmas are major barriers to uptake and retention in prevention of mother-to-child transmission (PMTCT) services and drive suboptimal adherence, and young women experience unique stigmas. Despite this, there are no evidence-based interventions to combat stigma and improve ART outcomes in this group. Peer support group interventions have shown promise in other populations, but have not been examined in young pregnant and postpartum women living with HIV. The investigators are conducting a pilot study of a peer support intervention to mitigate the negative effects of stigma in young pregnant and postpartum women living with HIV in South Africa. Participants will be allocated to the standard of care, in which no standardized peer support groups exist for this patient population, or to a peer support intervention.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 120
- Aged 16-24 years
- Documented HIV infection
- Confirmed pregnant or recently postpartum
- Accessing antenatal or immediate postpartum PMTCT services at the study site
- Planning on remaining a resident of Cape Town for at least 6 months after enrolment
- Able to provide informed consent for research
- Significant pre-existing psychiatric comorbidity that may impact ability to consent
- Stated intention to move outside of Cape Town during the 6 months after enrolment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Peer support intervention Peer support intervention Women will be invited to attend monthly peer support groups during pregnancy and postpartum, separate from any routine health services.
- Primary Outcome Measures
Name Time Method Retention and viral suppression After 6 months of follow-up Combined endpoint of (i) retention in HIV services and (ii) HIV viral suppression. Women will be considered to have achieved the primary outcome if they are both retained in care and virally suppressed.
- Secondary Outcome Measures
Name Time Method Psychosocial outcomes 6 months Psychosocial outcomes, including perceived social support and adherence self-efficacy, assessed using self-report questionnaires
Implementation of the intervention 6 months Implementation of the peer support intervention including standardization, assessed using logs and process notes completed by counsellors who will deliver the intervention
Acceptability of the intervention 6 months Acceptability of the peer support intervention, assessed as utilization and during in-depth interviews in a subset of participants
Health status 6 months Maternal and infant health status, assessed using self-report and routine medical records
Health service use 6 months Maternal and infant routine medical service use, assessed using self-report and routine medical records
Trial Locations
- Locations (1)
Gugulethu Community Health Centre
πΏπ¦Cape Town, Western Cape, South Africa