Masihambisane – Pregnant Women: KZN

 

There are four intersecting epidemics among pregnant women in South Africa: hazardous alcohol use (30%), HIV (27%), TB (60% of HIV+), and malnutrition (24% of infants). Unless the prevention programs for these epidemics are horizontally integrated, there will never be adequate resources to address these challenges and stigma will dramatically reduce program utilization. Since clinics are the typical sites for treating each of these health problems, the NIMH-funded Masihambisane study is examining a clinic-based prevention program delivered by neighborhood Mentor Mothers (MM) to reduce the consequences of hazardous alcohol use, HIV, TB, and poor nutrition. The intervention encourages mothers to care for their own health, parent well, maintain their mental health, and, if the mother is living with HIV (HIV+ MAR), reduce HIV transmission and/or reduce alcohol use and abuse. The results begin to inform the optimal delivery strategy for next generation of preventive interventions in order to be feasible and sustainable for broad dissemination immediately following an efficacy trial.

Targeted Risk Group: 

Mothers at risk for hazardous alcohol use, HIV, TB, and malnutrition, as well as their infants

Published Journal Articles :

  1. Pregnant Women Living with HIV (WLH) Supported at Clinics by Peer WLH: A Cluster Randomized Controlled Trial (0 downloads)
  2. A Cluster Randomized Controlled Trial Evaluating the Efficacy of Peer Mentors to Support South African Women Living with HIV and Their Infants (0 downloads)
  3. Qualitative interviews with mentor mothers living with HIV: potential impacts of role and coping strategies (0 downloads)
  4. Alcohol consumption among HIV-positive pregnant women in KwaZulu-Natal, South Africa: Prevalence and correlates (1 download)
  5. Project Masihambisane: a cluster randomized controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV (0 downloads)

Interventions, Training Manuals, etc. :  

Surveys and Scales Used: 

  1. TWEAK - Tolerance, Worried, Eye-opener, Amnesia, Cut down (0 downloads)
  2. Social Support (1 download)
  3. Traditional Medicines (0 downloads)
  4. Routines (0 downloads)
  5. Household Characteristics and Composition (2 downloads)
  6. Edinburgh Postnatal Depression Score (EPDS) (1 download)
  7. Maternal Health (0 downloads)
  8. Abuse (1 download)
  9. Maternal Knowledge of Vertical Transmission (0 downloads)
  10. Sexually Transmitted Disease (2 downloads)
  11. Audit C - Alcohol Use Disorders Identification Test (0 downloads)
  12. Maternal Knowledge of Child Health (0 downloads)
  13. Medication Adherence (5 downloads)
  14. CDC Sexual Behavior Questions (CSBQ) (6 downloads)
  15. HIV Disclosure (0 downloads)
  16. Alcohol and Other Drug Abuse (AOD) (5 downloads)
  17. Pregnancy History (1 download)
  18. HIV Testing Questions - CDC (CHTQ) (2 downloads)
  19. HIV Testing (0 downloads)
  20. General Medical History (0 downloads)
  21. General Health Questionnaire (1 download)

Intervention model:  

In the intervention arm, participants will receive the Department of Health-delivered Prevention of Mother to Child Transmission (PMTCT) program plus the Project Masihambisane mentor mothers support program, delivered by HIV-positive mentor mothers. HIV-positive mentor mothers are women who are thriving in the community and who have been through the PMTCT program. They have been recruited and trained to deliver the intervention to pregnant mothers living with HIV.

Research Methods: 

Eight clinics were randomly assigned to the intervention (4 clinics) or control condition (4 clinics). There are two levels of nesting in the study. Mothers and their infants are nested within clinics, and repeated observations over time are nested within individuals. Longitudinal random effect regression models will be used to account for the nesting and examine the efficacy of the intervention at improving the health of infants and their mothers over time.

Local Significance: 

The study is ongoing so it is too early to draw conclusions on the effectiveness of the intervention and the local significance.

International Significance: 

The study is ongoing so it is too early to draw conclusions on the effectiveness of the intervention and the local significance.