Emtonjeni-A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa: Results of a Phase II Study.
Identifieur interne : 000878 ( Main/Exploration ); précédent : 000877; suivant : 000879Emtonjeni-A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa: Results of a Phase II Study.
Auteurs : J E Mantell [États-Unis] ; D. Cooper [Afrique du Sud] ; T M Exner [États-Unis] ; J. Moodley [Afrique du Sud] ; S. Hoffman [États-Unis] ; L. Myer [Afrique du Sud] ; C-S Leu [États-Unis] ; D. Bai [États-Unis] ; E A Kelvin [États-Unis] ; K. Jennings [Afrique du Sud] ; Z A Stein [États-Unis] ; D. Constant [Afrique du Sud] ; V. Zweigenthal [Afrique du Sud] ; N. Cishe [Afrique du Sud] ; N. Nywagi [Afrique du Sud]Source :
- AIDS and behavior [ 1573-3254 ] ; 2017.
Abstract
Integration of sexual and reproductive health within HIV care services is a promising strategy for increasing access to family planning and STI services and reducing unwanted pregnancies, perinatal HIV transmission and maternal and infant mortality among people living with HIV and their partners. We conducted a Phase II randomized futility trial of a multi-level intervention to increase adherence to safer sex guidelines among those wishing to avoid pregnancy and adherence to safer conception guidelines among those seeking conception in newly-diagnosed HIV-positive persons in four public-sector HIV clinics in Cape Town. Clinics were pair-matched and the two clinics within each pair were randomized to either a three-session provider-delivered enhanced intervention (EI) (onsite contraceptive services and brief milieu intervention for staff) or standard-of-care (SOC) provider-delivered intervention. The futility analysis showed that we cannot rule out the possibility that the EI intervention has a 10 % point or greater success rate in improving adherence to safer sex/safer conception guidelines than does SOC (p = 0.573), indicating that the intervention holds merit, and a larger-scale confirmatory study showing whether the EI is superior to SOC has merit.
DOI: 10.1007/s10461-016-1562-z
PubMed: 27807792
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Emtonjeni-A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa: Results of a Phase II Study.</title><author><name sortKey="Mantell, J E" sort="Mantell, J E" uniqKey="Mantell J" first="J E" last="Mantell">J E Mantell</name><affiliation wicri:level="4"><nlm:affiliation>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA. jem57@cumc.columbia.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Cooper, D" sort="Cooper, D" uniqKey="Cooper D" first="D" last="Cooper">D. 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Cooper</name><affiliation wicri:level="1"><nlm:affiliation>School of Public Health, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health, University of the Western Cape, Private Bag X17, Bellville, 7535</wicri:regionArea><wicri:noRegion>7535</wicri:noRegion></affiliation></author><author><name sortKey="Exner, T M" sort="Exner, T M" uniqKey="Exner T" first="T M" last="Exner">T M Exner</name><affiliation wicri:level="4"><nlm:affiliation>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Moodley, J" sort="Moodley, J" uniqKey="Moodley J" first="J" last="Moodley">J. Moodley</name><affiliation wicri:level="1"><nlm:affiliation>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925</wicri:regionArea><wicri:noRegion>7925</wicri:noRegion></affiliation></author><author><name sortKey="Hoffman, S" sort="Hoffman, S" uniqKey="Hoffman S" first="S" last="Hoffman">S. Hoffman</name><affiliation wicri:level="4"><nlm:affiliation>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Myer, L" sort="Myer, L" uniqKey="Myer L" first="L" last="Myer">L. Myer</name><affiliation wicri:level="1"><nlm:affiliation>Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Leu, C S" sort="Leu, C S" uniqKey="Leu C" first="C-S" last="Leu">C-S Leu</name><affiliation wicri:level="4"><nlm:affiliation>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Bai, D" sort="Bai, D" uniqKey="Bai D" first="D" last="Bai">D. Bai</name><affiliation wicri:level="4"><nlm:affiliation>Department of Biostatistics and Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics and Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Kelvin, E A" sort="Kelvin, E A" uniqKey="Kelvin E" first="E A" last="Kelvin">E A Kelvin</name><affiliation wicri:level="4"><nlm:affiliation>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Jennings, K" sort="Jennings, K" uniqKey="Jennings K" first="K" last="Jennings">K. Jennings</name><affiliation wicri:level="1"><nlm:affiliation>City of Cape Town Department of Health, Cape Town, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>City of Cape Town Department of Health, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Stein, Z A" sort="Stein, Z A" uniqKey="Stein Z" first="Z A" last="Stein">Z A Stein</name><affiliation wicri:level="4"><nlm:affiliation>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gender, Sexuality and Health, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Constant, D" sort="Constant, D" uniqKey="Constant D" first="D" last="Constant">D. Constant</name><affiliation wicri:level="1"><nlm:affiliation>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925</wicri:regionArea><wicri:noRegion>7925</wicri:noRegion></affiliation></author><author><name sortKey="Zweigenthal, V" sort="Zweigenthal, V" uniqKey="Zweigenthal V" first="V" last="Zweigenthal">V. Zweigenthal</name><affiliation wicri:level="1"><nlm:affiliation>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Cishe, N" sort="Cishe, N" uniqKey="Cishe N" first="N" last="Cishe">N. Cishe</name><affiliation wicri:level="1"><nlm:affiliation>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925</wicri:regionArea><wicri:noRegion>7925</wicri:noRegion></affiliation></author><author><name sortKey="Nywagi, N" sort="Nywagi, N" uniqKey="Nywagi N" first="N" last="Nywagi">N. Nywagi</name><affiliation wicri:level="1"><nlm:affiliation>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925</wicri:regionArea><wicri:noRegion>7925</wicri:noRegion></affiliation></author></analytic><series><title level="j">AIDS and behavior</title><idno type="eISSN">1573-3254</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Integration of sexual and reproductive health within HIV care services is a promising strategy for increasing access to family planning and STI services and reducing unwanted pregnancies, perinatal HIV transmission and maternal and infant mortality among people living with HIV and their partners. We conducted a Phase II randomized futility trial of a multi-level intervention to increase adherence to safer sex guidelines among those wishing to avoid pregnancy and adherence to safer conception guidelines among those seeking conception in newly-diagnosed HIV-positive persons in four public-sector HIV clinics in Cape Town. Clinics were pair-matched and the two clinics within each pair were randomized to either a three-session provider-delivered enhanced intervention (EI) (onsite contraceptive services and brief milieu intervention for staff) or standard-of-care (SOC) provider-delivered intervention. The futility analysis showed that we cannot rule out the possibility that the EI intervention has a 10 % point or greater success rate in improving adherence to safer sex/safer conception guidelines than does SOC (p = 0.573), indicating that the intervention holds merit, and a larger-scale confirmatory study showing whether the EI is superior to SOC has merit.</div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>États-Unis</li></country><region><li>État de New York</li></region><settlement><li>New York</li></settlement><orgName><li>Université Columbia</li></orgName></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Mantell, J E" sort="Mantell, J E" uniqKey="Mantell J" first="J E" last="Mantell">J E Mantell</name></region><name sortKey="Bai, D" sort="Bai, D" uniqKey="Bai D" first="D" last="Bai">D. Bai</name><name sortKey="Exner, T M" sort="Exner, T M" uniqKey="Exner T" first="T M" last="Exner">T M Exner</name><name sortKey="Hoffman, S" sort="Hoffman, S" uniqKey="Hoffman S" first="S" last="Hoffman">S. Hoffman</name><name sortKey="Kelvin, E A" sort="Kelvin, E A" uniqKey="Kelvin E" first="E A" last="Kelvin">E A Kelvin</name><name sortKey="Leu, C S" sort="Leu, C S" uniqKey="Leu C" first="C-S" last="Leu">C-S Leu</name><name sortKey="Stein, Z A" sort="Stein, Z A" uniqKey="Stein Z" first="Z A" last="Stein">Z A Stein</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Cooper, D" sort="Cooper, D" uniqKey="Cooper D" first="D" last="Cooper">D. Cooper</name></noRegion><name sortKey="Cishe, N" sort="Cishe, N" uniqKey="Cishe N" first="N" last="Cishe">N. Cishe</name><name sortKey="Constant, D" sort="Constant, D" uniqKey="Constant D" first="D" last="Constant">D. Constant</name><name sortKey="Jennings, K" sort="Jennings, K" uniqKey="Jennings K" first="K" last="Jennings">K. Jennings</name><name sortKey="Moodley, J" sort="Moodley, J" uniqKey="Moodley J" first="J" last="Moodley">J. Moodley</name><name sortKey="Myer, L" sort="Myer, L" uniqKey="Myer L" first="L" last="Myer">L. Myer</name><name sortKey="Nywagi, N" sort="Nywagi, N" uniqKey="Nywagi N" first="N" last="Nywagi">N. Nywagi</name><name sortKey="Zweigenthal, V" sort="Zweigenthal, V" uniqKey="Zweigenthal V" first="V" last="Zweigenthal">V. Zweigenthal</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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