Efficacy of HIV Post-Test Support for ANC in South Africa
NCT ID: NCT01683461
Last Updated: 2012-09-12
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
1500 participants
INTERVENTIONAL
2008-05-31
2011-12-31
Brief Summary
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Through this intervention trial the investigators will be testing the following hypotheses:
H1: Women receiving the intervention will have significantly lower sexual risk of HIV at 14 weeks and 9-months post-partum as compared to women in the control arm. Sexual risk of HIV will be measured by: STI incidence (Trichomonas vaginalis, Neisseria gonorrhea and Chlamydia), consistent condom use, unprotected sex in past 30 days, and unprotected sex since delivery.
H2: Women receiving the intervention will report significantly better outcomes related to prevention of mother to child transmission (PMTCT) service uptake at 14 weeks and 9 months post-partum as compared to women in the control arm. PMTCT service uptake will be measured by acceptance of HIV VCT among HIV-positive and HIV-negative women; acceptance of ARVs, adherence to national infant feeding guidelines, and family planning use among HIV-positive women.
H3: Women in the intervention arm will report significantly better psychosocial outcomes at 14 weeks and 9 months post-partum as compared to women in the control arm. Psychosocial outcomes will be measured by: perceived social support, emotional distress, and partner violence among HIV-positive and HIV-negative women.
Detailed Description
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Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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Enhanced Counseling
Women in the intervention arm receive: (1) a standardized health education video before HIV pre-test counseling; (2) HIV pre- and post-test counseling sessions that prepare women for decisions related to testing, serostatus disclosure and anti-retroviral (ARV) prophylaxis and help women plan strategies for sexual risk behavior change; (3) two additional post-test counseling sessions postpartum focused on legal education and referral, partner testing, sexual risk behavior change and family planning decisions and; (4) an active referral system to post-test support groups run by a clinically trained staff psychologist and (5) an active referral system to legal services run by a lawyer at the clinic.
Enhanced Counseling
Women in the enhanced counseling arm receive the following intervention package: a video prior to their HIV pre-test counseling session that prepares them for decisions they will have to make regarding HIV testing and PMTCT participation, a pre-test counseling session and post-test counseling session with their nurse midwife/counselor, and two additional post-test counseling sessions with the same nurse midwife at 6 and 10 weeks postpartum. Women in the enhanced counseling arm also have access to ongoing support groups and legal support if needed at the clinic.
Standard of Care
Women in the control arm receive the standard of care in terms of HIV counseling and testing during pregnancy. The standard of care for HIV counseling adheres to guidelines provided by the US Centers for Disease Control and the World Health Organization. Women receive one individual pre-test counseling session immediately before they are tested for HIV, and one individual post-test counseling session the same day that they are tested.
Standard of Care
Women in the standard of care arm receive HIV pre and post-test counseling at their first antenatal visit. The counseling provided to them adheres to international guidelines for HIV counseling and testing developed by US CDC and the World Health Organization.
Interventions
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Enhanced Counseling
Women in the enhanced counseling arm receive the following intervention package: a video prior to their HIV pre-test counseling session that prepares them for decisions they will have to make regarding HIV testing and PMTCT participation, a pre-test counseling session and post-test counseling session with their nurse midwife/counselor, and two additional post-test counseling sessions with the same nurse midwife at 6 and 10 weeks postpartum. Women in the enhanced counseling arm also have access to ongoing support groups and legal support if needed at the clinic.
Standard of Care
Women in the standard of care arm receive HIV pre and post-test counseling at their first antenatal visit. The counseling provided to them adheres to international guidelines for HIV counseling and testing developed by US CDC and the World Health Organization.
Eligibility Criteria
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Inclusion Criteria
2. are not pregnant,
3. have never tested for HIV or had most recently tested negative for HIV at least 3 months prior to recruitment,
4. report having a primary partner who they have been with for at least 6 months,
5. plan to live in Durban for at least the next year,
6. plan to take their infant to the clinic for immunization visits,
7. are able to communicate in English or Zulu, and
8. do not need critical care for a high risk pregnancy that clinic staff is unable to provide.
Exclusion Criteria
2. are not pregnant;
3. have previously tested positive for HIV;
4. do not have a primary partner defined as someone they have been with for at least 6 months;
5. are not planning to reside in Durban for the next one year;
6. are unable to communicate in English or Zulu;
7. require care for high risk pregnancy that can not be provided by the clinic staff.
18 Years
FEMALE
No
Sponsors
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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
NIH
University of KwaZulu
OTHER
University of North Carolina, Chapel Hill
OTHER
Responsible Party
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Suzanne Maman
Associate Professor
Principal Investigators
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Suzanne Maman, PhD
Role: PRINCIPAL_INVESTIGATOR
University of North Carolina, Chapel Hill
Dhayendre Moodley, MMedSc, PhD
Role: PRINCIPAL_INVESTIGATOR
University of KwaZulu
Locations
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University of KwaZulu-Natal
Durban, , South Africa
Countries
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References
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Maman S, Moodley D, McNaughton-Reyes HL, Groves AK, Kagee A, Moodley P. Efficacy of enhanced HIV counseling for risk reduction during pregnancy and in the postpartum period: a randomized controlled trial. PLoS One. 2014 May 13;9(5):e97092. doi: 10.1371/journal.pone.0097092. eCollection 2014.
Other Identifiers
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07-1070
Identifier Type: -
Identifier Source: org_study_id