TY - JOUR
T1 - Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower)
T2 - A cluster randomised trial
AU - Ezeanolue, Echezona E.
AU - Obiefune, Michael C.
AU - Ezeanolue, Chinenye O.
AU - Ehiri, John E.
AU - Osuji, Alice
AU - Ogidi, Amaka G.
AU - Hunt, Aaron T.
AU - Patel, Dina
AU - Yang, Wei
AU - Pharr, Jennifer
AU - Ogedegbe, Gbenga
N1 - Funding Information:
This study was co-funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Institute of Mental Health (NIMH), and the US President's Emergency Plan for AIDS Relief (PEPFAR) under award number R01HD075050 to EEE. The full study operating procedure manual is available on the ClinicalTrials.gov website . We thank Healthy Sunrise Foundation, Bishop John Okoye (Catholic Bishop of Awgu diocese), Arch Bishop Emmanuel Chukwuma (Anglican Bishop of Enugu), Bishop Callistus Onaga (Catholic Bishop of Enugu), and Arch Bishop Amos Madu (Anglican Bishop of Oji-River); their support was instrumental to the successful implementation of HBI. HBI implementation would not have been possible without the support and tireless effort of the priests in the participating churches. The church-based volunteer health advisors took ownership of the programme and made the process of recruitment and implementation smooth for our study team and participants. This study would have been impossible to do without the support of PeTR-GS (our PEPFAR-supported partner) staff and volunteers.
Publisher Copyright:
© 2015 Ezeanolue et al.
PY - 2015/11
Y1 - 2015/11
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84944256492&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84944256492&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(15)00195-3
DO - 10.1016/S2214-109X(15)00195-3
M3 - Article
C2 - 26475016
AN - SCOPUS:84944256492
SN - 2214-109X
VL - 3
SP - e692-e700
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 11
ER -