Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV

Mary-Jane Rotheram-Borus, Linda Richter, Heidi Van Rooyen, Alastair van Heerden, Mark Tomlinson, Alan Stein, Tamsen Rochat, Julia de Kadt, Nonhle Mtungwa, Lungile Mkhize, Lindo Ndlovu, Lungile Ntombela, W Scott Comulada, Katherine A Desmond, Erin Greco, Mary-Jane Rotheram-Borus, Linda Richter, Heidi Van Rooyen, Alastair van Heerden, Mark Tomlinson, Alan Stein, Tamsen Rochat, Julia de Kadt, Nonhle Mtungwa, Lungile Mkhize, Lindo Ndlovu, Lungile Ntombela, W Scott Comulada, Katherine A Desmond, Erin Greco

Abstract

Background: Pregnant women living with HIV (WLH) face daily challenges maintaining their own and their babies' health and mental health. Standard Prevention of Maternal to Child Transmission (PMTCT) programs are not designed to address these challenges.

Methods/design: As part of a cluster randomized controlled trial, WLH are invited to attend four antenatal and four postnatal small group sessions led by a peer WLH (a Peer Mentor). The WLH and their babies are assessed during pregnancy and at one week, six months, and twelve months post-birth. Mobile phones are used to collect routine information, complete questionnaires and remain in contact with participants over time. Pregnant WLH (N = 1200) are randomly assigned by clinic (N = 8 clinics) to an intervention program, called Masihambisane (n = 4 clinics, n = 600 WLH) or a standard care PMTCT control condition (n = 4 clinics; n = 600 WLH).

Discussion: Data collection with cellular phones are innovative and effective in low-resource settings. Standard PMTCT programs are not designed to address the daily challenges faced by WLH; Peer Mentors may be useful in supporting WLH to cope with these challenges.

Trial registration: ClinicalTrials.gov registration # NCT00972699.

Figures

Figure 1
Figure 1
Geographic location of Mashihambisane clinics.
Figure 2
Figure 2
Participant flow through RCT.

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