PMID- 30134772 OWN - NLM STAT- MEDLINE DCOM- 20181224 LR - 20181224 IS - 1813-4424 (Electronic) IS - 1729-0376 (Print) IS - 1729-0376 (Linking) VI - 15 IP - 1 DP - 2018 Dec TI - Effect of a multicomponent behavioural PMTCT cluster randomised controlled trial on HIV stigma reduction among perinatal HIV positive women in Mpumalanga province, South Africa. PG - 80-88 LID - 10.1080/17290376.2018.1510787 [doi] AB - BACKGROUND: We evaluate the impact a multicomponent, behavioural, prevention of mother to child transmission (PMTCT), cluster randomised controlled trial on HIV stigma reduction among perinatal HIV infected women in rural South Africa. METHODS: In a cluster randomised controlled trial, twelve community health centres (CHCs) in Mpumalanga Province, South Africa, were randomised; pregnant women living with HIV enrolled received either: A Standard Care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n =357), or an Enhanced Intervention (EI) condition of SC PMTCT plus the 'Protect Your Family' intervention (EI; 6 CHCs; n =342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions; those in the EI, four antenatal and two postnatal group PMTCT sessions, including stigma reduction, led by trained lay health workers. Maternal PMTCT, HIV knowledge and HIV related stigma were assessed. The impact of the EI was ascertained on stigma reduction (baseline, 12 months postnatally). A series of logistic regression and latent growth curve models were developed to test the impact of the intervention. RESULTS: In all, 699 women living with HIV were recruited during pregnancy (8-24 weeks), and assessments were completed prenatally at baseline and at 12 months (59.5%) postnatally. Baseline scores of overall HIV related stigma and the four scale factors (personalised stigma, disclosure concerns, negative self-image, and concern public attitudes) decreased at follow-up in the intervention group, while baseline scores of overall stigma and three scale factors (personalised stigma, negative self-image, and concern public attitudes) increased at follow-up in the control group. Using longitudinal analyses, Model 1, which included time-invariant predictors of stigma assessed over the two time periods of baseline and 12 months, increases in stigma from baseline to 12 months were associated with being unemployed, having been diagnosed with HIV before the current pregnancy, and alcohol use. In Model 2, which included time-varying predictors, lower stigma scores were associated with participation in the intervention, greater male partner involvement, and consistent condom use. CONCLUSION: The enhanced PMTCT intervention, including stigma reduction, administered by trained lay health workers had a significant effect on the reduction of HIV related stigma. TRIAL REGISTRATION: clinicaltrials.gov: number NCT02085356. FAU - Peltzer, Karl AU - Peltzer K AUID- ORCID: 0000-0002-5980-0876 AD - a HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council , Pretoria , South Africa. AD - b Department of Research & Innovation , University of Limpopo , Sovenga , South Africa. FAU - Babayigit, Suat AU - Babayigit S AD - c Department of Psychiatry & Behavioral Sciences , University of Miami Miller School of Medicine , Miami , Florida , USA. FAU - Rodriguez, Violeta J AU - Rodriguez VJ AD - c Department of Psychiatry & Behavioral Sciences , University of Miami Miller School of Medicine , Miami , Florida , USA. AD - d Department of Psychology , University of Georgia , Athens , Georgia , USA. FAU - Jean, Jenny AU - Jean J AD - e University of Rochester , Rochester , New York , USA. FAU - Sifunda, Sibusiso AU - Sifunda S AUID- ORCID: 0000-0002-8766-7240 AD - a HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council , Pretoria , South Africa. FAU - Jones, Deborah L AU - Jones DL AUID- ORCID: 0000-0002-4106-8891 AD - c Department of Psychiatry & Behavioral Sciences , University of Miami Miller School of Medicine , Miami , Florida , USA. AD - f Department of Psychiatry , University of Zambia School of Medicine , Lusaka , Zambia. LA - eng SI - ClinicalTrials.gov/NCT02085356 GR - R01 HD078187/HD/NICHD NIH HHS/United States GR - K23 HD074489/HD/NICHD NIH HHS/United States GR - P30 AI073961/AI/NIAID NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PL - South Africa TA - SAHARA J JT - SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance JID - 101226212 RN - 0 (Anti-HIV Agents) SB - IM MH - Adult MH - Anti-HIV Agents/*therapeutic use MH - Cluster Analysis MH - Female MH - HIV Infections/drug therapy/prevention & control/*psychology MH - Health Knowledge, Attitudes, Practice MH - Health Promotion MH - Humans MH - Infectious Disease Transmission, Vertical/prevention & control/*statistics & numerical data MH - Longitudinal Studies MH - Pregnancy MH - Pregnancy Complications, Infectious/drug therapy/*psychology MH - Prenatal Care/*methods MH - Rural Population MH - Sexual Partners/*psychology MH - *Social Stigma MH - Social Support MH - South Africa/epidemiology MH - Young Adult PMC - PMC6116698 OTO - NOTNLM OT - Prevention of Mother to Child Transmission of HIV (PMTCT) OT - Randomized controlled trial OT - South Africa OT - behavioural intervention OT - stigma EDAT- 2018/08/24 06:00 MHDA- 2018/12/26 06:00 PMCR- 2018/08/22 CRDT- 2018/08/24 06:00 PHST- 2018/08/24 06:00 [entrez] PHST- 2018/08/24 06:00 [pubmed] PHST- 2018/12/26 06:00 [medline] PHST- 2018/08/22 00:00 [pmc-release] AID - 1510787 [pii] AID - 10.1080/17290376.2018.1510787 [doi] PST - ppublish SO - SAHARA J. 2018 Dec;15(1):80-88. doi: 10.1080/17290376.2018.1510787.