A Systematic Review of Behavioral Couples-Based Interventions Targeting Prevention of Mother-to-Child Transmission in Low- and Middle-Income Countries

AIDS and Behavior - There is increasing focus in HIV prevention and treatment on couples-based approaches. No systematic review has synthesized prospective behavioral couples-based HIV trials...     

No One-Size-Fits-All: Sexual Health Education Preferences in Patients with Breast Cancer

Annals of Surgical Oncology - Using explanatory mixed methods, we characterize the education that patients with breast cancer received about potential sexual health effects of treatment and explore...     

Effects of behavioural interventions on postpartum retention and adherence among women with HIV on lifelong ART: the results of a cluster randomized trial in Kenya (the MOTIVATE trial)

Introduction Retention in HIV care and adherence to antiretroviral therapy (ART) during pregnancy and postpartum for women living with HIV (WLWH) are necessary to optimize health outcomes for women and infants. The objective of this study was to evaluate the impact of two evidenced‐based behavioural interventions on postpartum adherence and retention in WLWH in Kenya.MethodsThe Mother‐Infant Visit Adherence and Treatment Engagement (MOTIVATE) study was a cluster‐randomized trial enrolling pregnant WLWH from December 2015 to August 2017. Twenty‐four health facilities in southwestern Kenya were randomized to: (1) standard care (control), (2) text‐messaging, (3) community‐based mentor mothers (cMM) or (4) text‐messaging and cMM. Primary outcomes included retention in care and ART adherence at 12 months postpartum. Analyses utilized generalized estimating equations and competing risks regression. Per‐protocol analyses examined differences in postpartum retention for women with high versus low levels of exposure to the interventions.Results We enrolled 1331 pregnant WLWH (mean age 28 years). At 12 months postpartum, 1140 (85.6%) women were retained in care, 96 women (7.2%) were lost‐to‐follow‐up (LTFU) and 95 (7.1%) were discontinued from the study. In intention‐to‐treat analyses, the relative risk of being retained at 12‐months postpartum was not significantly higher in the intervention arms versus the control arm. In time‐to‐event analysis, the cMM and text arm had significantly lower rates of LTFU (hazard ratio 0.44, p = 0.019). In per‐protocol analysis, the relative risk of 12‐month postpartum retention was 24–29% higher for women receiving at least 80% of the expected intervention compared to the control arm; text message only risk ratio (RR) 1.24 (95% confidence interval [CI] 1.16–1.32, p<0.001), cMM only RR 1.29 (95% CI 1.21–1.37, p<0.001) and cMM plus text RR 1.29 (1.21–1.37, p<0.001). Women LTFU were younger (p<0.001), less likely to be married (p<0.001) and more likely to be newly diagnosed with HIV during pregnancy (p<0.001). Self‐reported ART adherence did not vary by study arm.ConclusionsBehavioural interventions using peer support and text messages did not appear to improve 12‐month postpartum retention and adherence in intention‐to‐treat analyses. Higher levels of exposure to the interventions may be necessary to achieve the desired effects.     

Intimate Partner Violence Against HIV-Positive Women is Associated with Sub-Optimal Infant Feeding Practices in Lusaka,Zambia

Maternal and Child Health Journal - Objectives The aim of this study is to determine how intimate partner violence against HIV-positive women affects safe infant feeding practices in Lusaka,...     

ASO Visual Abstract: No One-Size-Fits-All: Sexual Health Education Preferences in Patients with Breast Cancer

Annals of Surgical Oncology -     

Perceptions of health care services and HIV-related health-seeking behavior among Uganda adolescents

Youth represent almost half of all new HIV infections globally. Although condom use is an effective method of HIV prevention among sexually active youth in sub-Saharan Africa (SSA), they face substantial barriers in obtaining condoms in environments where adults hold attitudes condemning premarital sex. More research is needed to better understand the multitude of factors that affect SSA youths' behaviors regarding safe sex practices, including factors that may influence their ability to obtain condoms, and decisions to be tested for HIV. In this study of Uganda youth (n = 1503) from five secondary schools, logistic regression models highlight factors that influence perceptions regarding respect and confidentiality at health centers, condom acquisition, and HIV testing. Family support appears to be an especially important factor that affects youth perceptions about how they will be treated when seeking condoms and HIV testing. Condom acquisition and HIV-testing behaviors are also associated with peer influence, self-esteem, and demographic characteristics, such as age.     

Virtual Prenatal and Postpartum Care Acceptability Among Maternity Care Providers

Maternal and Child Health Journal - The Covid-19 pandemic and statewide stay-at-home orders abruptly impacted clinic operations necessitating the incorporation of telehealth. Uptake of telehealth...