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 : 000896 ( PubMed/Curation ); précédent : 000895; suivant : 000897Emtonjeni-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
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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></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="1"><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></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></affiliation></author><author><name sortKey="Hoffman, S" sort="Hoffman, S" uniqKey="Hoffman S" first="S" last="Hoffman">S. Hoffman</name><affiliation wicri:level="1"><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></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></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="1"><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></affiliation></author><author><name sortKey="Bai, D" sort="Bai, D" uniqKey="Bai D" first="D" last="Bai">D. Bai</name><affiliation wicri:level="1"><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></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="1"><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></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></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="1"><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></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></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></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></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></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><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">27807792</PMID><DateCreated><Year>2016</Year><Month>11</Month><Day>03</Day></DateCreated><DateRevised><Year>2017</Year><Month>08</Month><Day>12</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1573-3254</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>3</Issue><PubDate><Year>2017</Year><Month>Mar</Month></PubDate></JournalIssue><Title>AIDS and behavior</Title><ISOAbbreviation>AIDS Behav</ISOAbbreviation></Journal><ArticleTitle>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.</ArticleTitle><Pagination><MedlinePgn>905-922</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s10461-016-1562-z</ELocationID><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mantell</LastName><ForeName>J E</ForeName><Initials>JE</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cooper</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>School of Public Health, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Exner</LastName><ForeName>T M</ForeName><Initials>TM</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moodley</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hoffman</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Myer</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leu</LastName><ForeName>C-S</ForeName><Initials>CS</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Biostatistics and Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bai</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Biostatistics and Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kelvin</LastName><ForeName>E A</ForeName><Initials>EA</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Epidemiology and Biostatistics Department, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jennings</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>City of Cape Town Department of Health, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stein</LastName><ForeName>Z A</ForeName><Initials>ZA</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Constant</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zweigenthal</LastName><ForeName>V</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cishe</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nywagi</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>P30 MH043520</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 MH078770</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>AIDS 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RefType="Cites"><RefSource>J Infect Dis. 2007 Aug 15;196 Suppl 1:S114-23</RefSource><PMID Version="1">17624820</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Int AIDS Soc. 2014 Mar 12;17:18832</RefSource><PMID Version="1">24629843</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Contraception</Keyword><Keyword MajorTopicYN="N">HIV-positive women and men</Keyword><Keyword MajorTopicYN="N">Integration of sexual and reproductive health and HIV services</Keyword><Keyword MajorTopicYN="N">Safer conception</Keyword><Keyword MajorTopicYN="N">South Africa</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pmc-release"><Year>2018</Year><Month>03</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>11</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>11</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>11</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27807792</ArticleId><ArticleId IdType="doi">10.1007/s10461-016-1562-z</ArticleId><ArticleId IdType="pii">10.1007/s10461-016-1562-z</ArticleId><ArticleId IdType="pmc">PMC5552040</ArticleId><ArticleId IdType="mid">NIHMS827444</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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