Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower): a cluster randomised trial
Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower): a cluster randomised trial
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DOI：
10.1016/s2214-109x(15)00195-3
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发表时间：
2015-11-01
影响因子：
34.3
通讯作者：
Ogedegbe, Gbenga
中科院分区：
文献类型：
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作者：
Ezeanolue, Echezona E.;Obiefune, Michael C.;Ogedegbe, Gbenga
背景：几乎没有有效的社区干预措施来提高资源有限地区孕妇的HIV检测和抗逆转录病毒疗法(ART)的接受度。我们评估了通过教堂提供干预措施，即健康开始倡议，是否会增加孕妇对艾滋病毒检测的接受程度，而不是标准的医疗机构转诊。方法在这项随机分组试验中，我们招募了18岁及以上的自我认同的孕妇，她们参加了尼日利亚东南部的教堂。我们将教堂(集群)随机分为干预组或对照组，按平均每年婴儿洗礼次数(=80)分层。健康开始倡议干预措施包括在干预组教堂的婴儿送礼会期间实施的健康教育和现场实验室测试，而对照组教堂的参与者被认为是卫生设施的标准。参与者和调查人员都知道教堂的分配情况。主要结果是确认了艾滋病毒检测。这项试验在ClinicalTrials.gov注册，识别号为NCT 01795261。在2013年1月20日至2014年8月31日期间，我们在40个教堂招募了3002名参与者(每组20人)。干预组1647名妇女中有1309人(79%)参加了产前护理，而对照组1355人中有1080人(80%)参加了产前护理。干预组有1514名妇女(92%)接受了HIV检测，而对照组有740名妇女(55%)(调整后的优势比为11.2，95%可信区间为8.77-14.25；p
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). 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