Acceptability of a Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-exposure Prophylaxis Adherence During Pregnancy and Breastfeeding in Malawi.
Antiretroviral drugs
HIV
Mixed methods
Pre-exposure prophylaxis
Pregnancy and breastfeeding
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:
18
06
2023
pubmed:
1
7
2023
medline:
1
7
2023
entrez:
1
7
2023
Statut:
ppublish
Résumé
In two parallel pilot studies, we implemented a combination adherence intervention of patient-centered counselling and adherence supporter training, tailored to support HIV treatment (i.e., antiretroviral therapy) or prevention (i.e., pre-exposure prophylaxis, or PrEP) during pregnancy and breastfeeding. Using a mixed-methods approach, we evaluated the intervention's acceptability. We investigated engagement, satisfaction, and discussion content via survey to all 151 participants assigned to the intervention arm (51 women living with HIV, 100 PrEP-eligible women without HIV). We also conducted serial in-depth interviews with a subgroup (n = 40) at enrollment, three months, and six months. In the quantitative analysis, the vast majority reported high satisfaction with intervention components and expressed desire to receive it in the future, if made available. These findings were supported in the qualitative analysis, with favorable comments about counselor engagement, intervention content and types of support received from adherence supporters. Overall, these results demonstrate high acceptability and provide support for HIV status-neutral interventions for antiretroviral adherence.
Identifiants
pubmed: 37392270
doi: 10.1007/s10461-023-04116-x
pii: 10.1007/s10461-023-04116-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4022-4032Subventions
Organisme : NIAID NIH HHS
ID : R01 AI131060
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI120796
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009340
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW010060
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : NIMH NIH HHS
ID : K01 MH121186
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI131060
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI120796
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009340
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW010060
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : NIMH NIH HHS
ID : K01 MH121186
Pays : United States
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Mugwaneza P, Lyambabaje A, Umubyeyi A, Humuza J, Tsague L, Mwanyumba F, et al. Impact of maternal ART on mother-to-child transmission (MTCT) of HIV at six weeks postpartum in Rwanda. BMC Public Health. 2018 Nov;12(1):1248.
Kamuyango AA, Hirschhorn LR, Wang W, Jansen P, Hoffman RM. One-year outcomes of women started on antiretroviral therapy during pregnancy before and after the implementation of Option B + in Malawi: A retrospective chart review - PMC [Internet]. [cited 2022 May 11]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356991/
Kim MH, Ahmed S, Hosseinipour MC et al. Brief Report: Impact of Option B + on the Infant PMTCT Cascade in Lilongwe, Malawi - PMC [Internet]. [cited 2022 May 11]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4537054/
Rollins NC, Doherty M, Hirnschall GO. Improving Retention in Care among pregnant women and mothers living with HIV: Lessons from INSPIRE and Implications for Future WHO Guidance and Monitoring. J Acquir Immune Defic Syndr. 2017;75:4.
doi: 10.1097/QAI.0000000000001366
Drake AL, Wagner A, Richardson B, John-Stewart G, Incident. HIV during pregnancy and Postpartum and Risk of Mother-to-child HIV Transmission: a systematic review and Meta-analysis. PLoS Med. 2014 Feb;25(2):e1001608.
Graybill LA, Kasaro M, Freeborn K, Walker JS, Poole C, Powers KA, et al. Incident HIV among pregnant and breast-feeding women in sub-saharan Africa: a systematic review and meta-analysis. AIDS. 2020;01(5):761–76.
doi: 10.1097/QAD.0000000000002487
Thomson KA, Hughes J, Baeten JM, John-Stewart G, Celum C, Cohen CR et al. Increased risk of HIV Acquisition among Women throughout pregnancy and during the Postpartum period: a prospective per-coital-act analysis among women with HIV-Infected Partners. J Infect Dis 2018 Jun 5;218(1):16–25.
UNAIDS, Start Free S, Free. AIDS Free — Final report on 2020 targets | UNAIDS [Internet]. [cited 2022 May 10]. Available from: https://www.unaids.org/en/resources/documents/2021/start-free-stay-free-aids-free-final-report-on-2020-targets
Hoffman RM, Newhouse C, Chu B, Stringer JSA, Currier JS. Non-communicable Diseases in Pregnant and Postpartum Women Living with HIV: Implications for Health Throughout the Life Course - PubMed [Internet]. [cited 2022 May 11]. Available from: https://pubmed.ncbi.nlm.nih.gov/33400169/
Dinh TH, Delaney KP, Goga A, Jackson D, Lombard C et al. (2015). Impact of Maternal HIV Seroconversion during Pregnancy on Early Mother to Child Transmission of HIV (MTCT) Measured at 4–8 Weeks Postpartum in South Africa 2011–2012: A National Population-Based Evaluation | PLOS ONE [Internet]. [cited 2022 May 10]. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125525
UNAIDS, Improving. UNAIDS’ paediatric and adolescent estimates [Internet]. Geneva, Switzerland: UNAIDS; 2020 [cited 2020 Jun 21]. Available from: https://www.unaids.org/sites/default/files/media_asset/improving-unaids-paediatric-and-adolescent-estimates_en.pdf
UNICEF. Levels and trends in child mortality 2020 | UNICEF [Internet]. 2020 [cited 2022 Apr 24]. Available from: https://www.unicef.org/reports/levels-and-trends-child-mortality-report-2020
Murnane PM, Celum C, Mugo N, Campbell JD, Donnell D, Bukusi E, et al. Efficacy of preexposure prophylaxis for HIV-1 prevention among high-risk heterosexuals: subgroup analyses from a randomized trial. AIDS. 2013 Aug;27(13):2155–60.
Thomson KA, Baeten JM, Mugo NR, Bekker LG, Celum CL, Heffron R. Tenofovir-based oral preexposure prophylaxis prevents HIV infection among women. Curr Opin HIV AIDS. 2016 Jan;11(1):18–26.
Joseph Davey DL, Bekker LG, Gorbach PM, Coates TJ, Myer L. Delivering preexposure prophylaxis to pregnant and breastfeeding women in Sub-Saharan Africa: the implementation science frontier. AIDS. 2017 Oct;23(16):2193–7.
Heffron R, McClelland RS, Balkus JE, Celum C, Cohen CR, Mugo N, et al. Efficacy of oral pre-exposure prophylaxis (PrEP) for HIV among women with abnormal vaginal microbiota: a post-hoc analysis of the randomised, placebo-controlled Partners PrEP Study. The Lancet HIV. 2017 Oct;4(10):e449–56.
WHO. Preventing HIV during pregnancy and breastfeeding in the context of PrEP [Internet]. Geneva, Switzerland: WHO. ; 2017 [cited 2020 Jun 4]. Available from: http://www.who.int/hiv/pub/toolkits/prep-preventing-hiv-during-pregnancy/en/
Pintye J, O’Malley G, Kinuthia J, Abuna F, Escudero JN, Mugambi M et al. Influences on Early Discontinuation and Persistence of Daily Oral PrEP Use Among Kenyan Adolescent Girls and Young Women: A Qualitative Evaluation From a PrEP Implementation Program. J Acquir Immune Defic Syndr. 2021 Apr 1;86(4):e83–9.
Joseph Davey DL, Mvududu R, Mashele N, Lesosky M, Khadka N, Bekker LG, et al. Early pre-exposure prophylaxis (PrEP) initiation and continuation among pregnant and postpartum women in antenatal care in Cape Town, South Africa. J Int AIDS Soc. 2022;25(2):e25866.
doi: 10.1002/jia2.25866
pubmed: 35138678
pmcid: 8826542
Kinuthia J, Pintye J, Abuna F, Mugwanya KK, Lagat H, Onyango D, et al. Pre-exposure prophylaxis uptake and early continuation among pregnant and post-partum women within maternal and child health clinics in Kenya: results from an implementation programme. Lancet HIV. 2020 Jan;7(1):e38–48.
Zimba C, Maman S, Rosenberg NE, Mutale W, Mweemba O, Dunda W, et al. The landscape for HIV pre-exposure prophylaxis during pregnancy and breastfeeding in Malawi and Zambia: a qualitative study. PLoS ONE. 2019;14(10):e0223487.
doi: 10.1371/journal.pone.0223487
pubmed: 31584987
pmcid: 6777778
Powers KA, Orroth K, Rosenberg NE, Graybill LA, Kumwenda A, Mtande T et al. A Mathematical Modeling Analysis of Combination HIV Prevention in Antenatal Clinics.:1.
Amico KR, Barta W, Konkle-Parker DJ, Fisher JD, Cornman DH, Shuper PA, et al. The information–motivation–behavioral skills model of ART Adherence in a Deep South HIV + Clinic Sample. AIDS Behav. 2009 Feb;13(1):66–75.
Amico KR, Miller J, Balthazar C, Serrano PA, Brothers J, Zollweg S, et al. Integrated Next Step Counseling (iNSC) for sexual Health and PrEP Use among Young Men who have sex with men: implementation and observations from ATN110/113. AIDS Behav. 2019 Jul;23(7):1812–23.
Christopher Chianese K, Rivet Amico K, Mayer A, Liu V, Mcmahan S, Hosek M, Mehrotra, Grant R. Integrated Next Step Counseling for Sexual Health Promotion and Medication Adherence for Individuals Using Pre-exposure Prophylaxis | AIDS Research and Human Retroviruses [Internet]. [cited 2022 Jul 19]. Available from: https://www.liebertpub.com/doi/abs/ https://doi.org/10.1089/aid.2014.5329.abstract
Saidi F, Mutale W, Freeborn K, Rosenberg NE, Graybill LA, Maman S, et al. Combination adherence strategy to support HIV antiretroviral therapy and pre-exposure prophylaxis adherence during pregnancy and breastfeeding: protocol for a pair of pilot randomised trials. BMJ Open. 2021 Jun;11(6):e046032.
Ministry of Health and Population, Malawi. 2018 Clinical Management of HIV in Children and Adults. 4th ed. Lilongwe: Ministry of Health and Population, Malawi; 2018.
Hill LM, Saidi F, Freeborn K, Amico KR, Rosenberg NE et al. (2021). Tonse Pamodzi: Developing a combination strategy to support adherence to antiretroviral therapy and HIV pre-exposure prophylaxis during pregnancy and breastfeeding | PLOS ONE [Internet]. [cited 2022 May 10]. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253280
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007 Dec 1;19(6):349–57.
Ayala GX, Elder JP. Qualitative methods to ensure acceptability of behavioral and social interventions to the target population: qualitative methods in acceptability research. J Public Health Dent. 2011 Jan;71:69–79.
Grodensky CA, Golin CE, Pack AP, Pettifor A, Demers M, Massa C, et al. Adaptation and delivery of a motivational interviewing-based counseling program for persons acutely infected with HIV in Malawi: implementation and lessons learned. Patient Educ Couns. 2018 Jun;101(6):1103–9.
Cooper LA, Hill MN, Powe NR. Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. J Gen Intern Med. 2002 Jun;17(6):477–86.
Jones HS, Floyd S, Stangl A, Bond V, Hoddinott G, Pliakas T, et al. Association between HIV stigma and antiretroviral therapy adherence among adults living with HIV: baseline findings from the HPTN 071 (PopART) trial in Zambia and South Africa. Tropical Med Int Health. 2020;25(10):1246–60.
doi: 10.1111/tmi.13473
Berner-Rodoreda A, Ngwira E, Alhassan Y, Chione B, Dambe R, Bärnighausen T et al. “Deadly”, “fierce”, “shameful”: notions of antiretroviral therapy, stigma and masculinities intersecting men’s life-course in Blantyre, Malawi. BMC Public Health. 2021 Dec 11;21(1):2247.
Nachega JB, Knowlton AR, Deluca A, Schoeman JH, Watkinson L, Efron A, et al. Treatment supporter to improve adherence to antiretroviral therapy in HIV-Infected south african adults: a qualitative study. JAIDS J Acquir Immune Defic Syndr. 2006 Dec;43(1):127.
Barbacci M, Chaisson RE, Repke JT. Routine prenatal screening for HIV infection. The Lancet. 1991 Mar;23(8743):709–11.
Rosenberg NE, Graybill LA, Wesevich A, McGrath N, Golin CE, Maman S et al. The Impact of Couple HIV Testing and Counseling on Consistent Condom Use among Pregnant Women and their Male Partners: An Observational Study. J Acquir Immune Defic Syndr. 2017 Aug 1;75(4):417–25.
Delany-Moretlwe S, Hughes JP, Bock P, Ouma SG, Hunidzarira P, Kalonji D et al. Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial. The Lancet [Internet]. 2022 Apr 1 [cited 2022 Apr 17]; Available from: https://www.sciencedirect.com/science/article/pii/S0140673622005384
Vickerman P, Quaife M, Kilbourne-Brook M, Mvundura M, Eakle R, Terris-Prestholt F. HIV prevention is not all about HIV – using a discrete choice experiment among women to model how the uptake and effectiveness of HIV prevention products may also rely on pregnancy and STI protection. BMC Infect Dis. 2020 Sep;25(1):704.