Peer Support to Mitigate the Impact of Stigma in Young HIV+ Pregnant & Postpartum Women

University of Cape Town (UCT)

Status: Completed

Conditions: Hiv

Treatments: Behavioral: Peer support intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT04036851

267/2019

Details and patient eligibility

About

Young pregnant and postpartum women living with HIV are at the greatest risk of disengagement from HIV services and suboptimal adherence to antiretroviral therapy (ART). Among young women, stigma is a major barrier to retention in services and adherence to ART, and interventions are needed to combat stigma and improve ART outcomes. The investigators are conducting a pilot study of a peer support intervention to mitigate the negative effects of stigma in this population.

Full description

Despite major reductions in mother-to-child HIV transmission (MTCT), young pregnant and postpartum women living with HIV remain a vulnerable group and experience the greatest risk of disengagement from services and suboptimal adherence to antiretroviral therapy (ART). HIV-related and intersectional stigmas are major barriers to uptake and retention in prevention of mother-to-child transmission (PMTCT) services and drive suboptimal adherence, and young women experience unique stigmas. Despite this, there are no evidence-based interventions to combat stigma and improve ART outcomes in this group. Peer support group interventions have shown promise in other populations, but have not been examined in young pregnant and postpartum women living with HIV. The investigators are conducting a pilot study of a peer support intervention to mitigate the negative effects of stigma in young pregnant and postpartum women living with HIV in South Africa. Participants will be allocated to the standard of care, in which no standardized peer support groups exist for this patient population, or to a peer support intervention.

Enrollment: 120 patients

Sex: Female

Ages: 16 to 24 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged 16-24 years
• Documented HIV infection
• Confirmed pregnant or recently postpartum
• Accessing antenatal or immediate postpartum PMTCT services at the study site
• Planning on remaining a resident of Cape Town for at least 6 months after enrolment
• Able to provide informed consent for research

Exclusion criteria

• Significant pre-existing psychiatric comorbidity that may impact ability to consent
• Stated intention to move outside of Cape Town during the 6 months after enrolment

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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120 participants in 2 patient groups

Local standard of care

No Intervention group

Description:

Women receive integrated antenatal and HIV services during pregnancy and are referred to general adult HIV services after delivery; no standardized peer support groups exist for this patient population.

Peer support intervention

Experimental group

Description:

Women will be invited to attend monthly peer support groups during pregnancy and postpartum, separate from any routine health services.

Treatment:

Behavioral: Peer support intervention