Why do Integrated Maternal HIV and Infant Healthcare Services work? A Secondary Analysis of a Randomised Controlled Trial in South Africa.
Integration
Intervention
PMTCT
Retention
South Africa
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
accepted:
20
05
2023
medline:
27
10
2023
pubmed:
12
6
2023
entrez:
12
6
2023
Statut:
ppublish
Résumé
In a randomised trial, we found that integrated maternal HIV and infant health services through the end of breastfeeding were significantly associated with the primary outcome of engagement in HIV care and viral suppression at 12 months postpartum, compared to the standard of care. Here, we quantitatively explore potential psychosocial modifiers and mediators of this association. Our findings suggest that the intervention was significantly more effective among women experiencing an unintended pregnancy but did not improve outcomes among women reporting risky alcohol use. Although not statistically significant, our results suggest that the intervention may also be more effective among women experiencing higher levels of poverty and HIV-related stigma. We observed no definitive mediator of the intervention effect, but women allocated to integrated services reported better relationships with their healthcare providers through 12 months postpartum. These findings point to high-risk groups that may benefit the most from integrated care, as well as groups for whom these benefits are hampered and that warrant further attention in intervention development and evaluation.
Identifiants
pubmed: 37306847
doi: 10.1007/s10461-023-04097-x
pii: 10.1007/s10461-023-04097-x
pmc: PMC10598190
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3831-3843Subventions
Organisme : NIMH NIH HHS
ID : K01 MH112443
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD074558
Pays : United States
Informations de copyright
© 2023. The Author(s).
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