Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower): a cluster randomised trial.

Autor:	Ezeanolue EE; School of Community Health Sciences, University of Nevada, Las Vegas, NV, USA. Electronic address: echezona.ezeanolue@unlv.edu., Obiefune MC; Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, Enugu, Enugu State, Nigeria., Ezeanolue CO; Healthy Sunrise Foundation, Las Vegas, NV, USA., Ehiri JE; Department of Health Promotion Sciences/Global Health Institute, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA., Osuji A; Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, Enugu, Enugu State, Nigeria., Ogidi AG; Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, Enugu, Enugu State, Nigeria., Hunt AT; Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, NV, USA., Patel D; Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, NV, USA., Yang W; School of Community Health Sciences, University of Nevada, Reno, NV, USA., Pharr J; School of Community Health Sciences, University of Nevada, Las Vegas, NV, USA., Ogedegbe G; New York University Langone Medical Center, and NYU College of Global Public Health, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	The Lancet. Global health [Lancet Glob Health] 2015 Nov; Vol. 3 (11), pp. e692-700.
DOI:	10.1016/S2214-109X(15)00195-3
Abstrakt:	Background: Few effective community-based interventions exist to increase HIV testing and uptake of antiretroviral therapy (ART) in pregnant women in hard-to-reach resource-limited settings. We assessed whether delivery of an intervention through churches, the Healthy Beginning Initiative, would increase uptake of HIV testing in pregnant women compared with standard health facility referral. Methods: In this cluster randomised trial, we enrolled self-identified pregnant women aged 18 years and older who attended churches in southeast Nigeria. We randomised churches (clusters) to intervention or control groups, stratified by mean annual number of infant baptisms (<80 vs ≥80). The Healthy Beginning Initiative intervention included health education and on-site laboratory testing implemented during baby showers in intervention group churches, whereas participants in control group churches were referred to health facilities as standard. Participants and investigators were aware of church allocation. The primary outcome was confirmed HIV testing. This trial is registered with ClinicalTrials.gov, identifier number NCT 01795261. Findings: Between Jan 20, 2013, and Aug 31, 2014, we enrolled 3002 participants at 40 churches (20 per group). 1309 (79%) of 1647 women attended antenatal care in the intervention group compared with 1080 (80%) of 1355 in the control group. 1514 women (92%) in the intervention group had an HIV test compared with 740 (55%) controls (adjusted odds ratio 11·2, 95% CI 8·77-14·25; p<0·0001). Interpretation: Culturally adapted, community-based programmes such as the Healthy Beginning Initiative can be effective in increasing HIV screening in pregnant women in resource-limited settings. Funding: US National Institutes of Health and US President's Emergency Plan for AIDS Relief. (Copyright © 2015 Ezeanolue et al. Open Access article published under the terms of CC BY-NC-ND. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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