Reducing the Risk of HIV Infection During Pregnancy among South African Women: A Randomized Controlled Trial

June 2013 - Behavioral Prevention

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Jones, D.L., Peltzer, K., Villar-Loubet, O., et al. AIDS Care (2013), Vol. 25 No. 6, pp. 702-709.

The authors used a group-randomized controlled study in rural South Africa to evaluate a “PartnerPlus” prevention of mother-to-child transmission (PMTCT) intervention. The intervention was conducted with 239 couples at 12 antenatal care (ANC) clinics. Of these couples, 119 were randomly assigned to receive the intervention (increasing male participation during pregnancy, condom use and HIV knowledge, and sexual communication through four weekly sessions on cognitive skills), and 120 couples received standard PMTCT with time-matched health education videos (control). At baseline, 32 percent of women and 16 percent of men were HIV-positive (24 percent of men declined testing); 26 couples were serodiscordant. At follow-up (32 weeks' gestation) unprotected sex had decreased, and no women had seroconverted in the intervention. While baseline HIV knowledge scores were similar, knowledge increased among intervention participants. The intervention group had an estimated 5.1 odds of increased condom use compared with the control. Further, sexual communication/negotiation strategies increased, and intimate partner violence diminished among intervention couples. Findings suggest that interventions targeting men during pregnancy may be more effective than only encouraging ANC attendance. Because neither group attained complete coverage of male HIV testing or mutual disclosure, future research should explore relevant interventions. The authors emphasized the importance of shared engagement between couples to reduce sexual risk behaviors during pregnancy.

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