Ezeanolue, E.E., Obiefune, M.C., Ezeanolue, C.O., et al. The Lancet Global Health (November 2015), (11): e692–700, doi: 10.1016/S2214-109X(15)00195-3.
Between January 2013 and August 2014, this two-arm cluster randomized trial compared the effects of a congregation-based intervention versus standard referral for testing on uptake of HIV testing by pregnant women in rural Enugu State, Nigeria. The church-based Healthy Beginning Initiative provided free, integrated, on-site laboratory tests during baby showers in 20 intervention churches, while women at baby showers at 20 control churches received referral to a health facility (the standard of care). The 3,002 participants in both intervention and control groups received three study visits: one at baseline (recruitment), one during the baby shower, and one at 6–8 weeks after delivery. The primary outcome was a confirmed HIV test during pregnancy. HIV prevalence did not differ between groups. However, women in the intervention group were more likely than those in the control group to be linked to care before delivery, and were more likely to access care and receive antiretroviral therapy during pregnancy. The authors concluded that a culturally adapted, congregation-based approach delivered by trained volunteer health advisors can be used effectively to increase HIV testing in pregnant women in remote regions of the country.