A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania

Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV...

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Autores principales:	Rohan D. Jeremiah, Dhruvi R. Patel, Ellen Chirwa, Esnath Kapito, Xiaohan Mei, Linda L. McCreary, Kathleen F. Norr, Li Liu, Crystal L. Patil
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Antenatal care Group healthcare Maternal and newborn health Partner communication HIV testing Sub-Saharan Africa Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/07836339dee94819bd13f46acf645080
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spelling	oai:doaj.org-article:07836339dee94819bd13f46acf6450802021-11-28T12:29:44ZA randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania10.1186/s12884-021-04267-61471-2393https://doaj.org/article/07836339dee94819bd13f46acf6450802021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04267-6https://doaj.org/toc/1471-2393Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.Rohan D. JeremiahDhruvi R. PatelEllen ChirwaEsnath KapitoXiaohan MeiLinda L. McCrearyKathleen F. NorrLi LiuCrystal L. PatilBMCarticleAntenatal careGroup healthcareMaternal and newborn healthPartner communicationHIV testingSub-Saharan AfricaGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Antenatal care Group healthcare Maternal and newborn health Partner communication HIV testing Sub-Saharan Africa Gynecology and obstetrics RG1-991
spellingShingle	Antenatal care Group healthcare Maternal and newborn health Partner communication HIV testing Sub-Saharan Africa Gynecology and obstetrics RG1-991 Rohan D. Jeremiah Dhruvi R. Patel Ellen Chirwa Esnath Kapito Xiaohan Mei Linda L. McCreary Kathleen F. Norr Li Liu Crystal L. Patil A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
description	Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.
format	article
author	Rohan D. Jeremiah Dhruvi R. Patel Ellen Chirwa Esnath Kapito Xiaohan Mei Linda L. McCreary Kathleen F. Norr Li Liu Crystal L. Patil
author_facet	Rohan D. Jeremiah Dhruvi R. Patel Ellen Chirwa Esnath Kapito Xiaohan Mei Linda L. McCreary Kathleen F. Norr Li Liu Crystal L. Patil
author_sort	Rohan D. Jeremiah
title	A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
title_short	A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
title_full	A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
title_fullStr	A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
title_full_unstemmed	A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
title_sort	randomized group antenatal care pilot showed increased partner communication and partner hiv testing during pregnancy in malawi and tanzania
publisher	BMC
publishDate	2021
url	https://doaj.org/article/07836339dee94819bd13f46acf645080
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A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania

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