Mamekhaya: a pilot study combining a cognitive-behavioral intervention and mentor mothers with PMTCT services in South Africa
Mamekhaya: a pilot study combining a cognitive-behavioral intervention and mentor mothers with PMTCT services in South Africa
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DOI：
10.1080/09540121003600352
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Greco, Erin
中科院分区：
文献类型：
--
作者：
Futterman, Donna;Shea, Jawaya;Greco, Erin
据估计，南非近30%的孕妇艾滋病毒血清反应呈阳性，但遵守预防母婴传播艾滋病毒（PMTCT）准则的情况往往很低。开展了一项试点研究，以了解Mamekhaya方案是否可以加强南非政府提供的预防母婴传播服务，该方案是mothers2mothers同伴指导方案和美国文化适应性认知行为干预措施的结合。在南非开普敦Gugulethu和Vanguard Townships的两家提供预防母婴传播的产科诊所就诊的孕妇被邀请参加这项研究。在干预地点（Gugulethu）的妇女得到了一位母亲导师的支持，并参加了八届Mamekhaya CBI。在对照点（先锋），妇女接受助产士和咨询师提供的标准服务。所有参与者在入组时完成了基线评估（n=160），44%的参与者在6个月后完成了随访。两个地点遵守预防母婴传播做法的自我报告都很高（90%或更多参与核心做法）。在Mamekhaya站点的妇女在建立社会支持和降低抑郁评分方面比对照站点的妇女表现出更大的改善。Mamekhaya参与者还显示出更好地参加后续医疗访问的趋势，以及积极应对的更大改善。Mamekhaya计划的最大效果是提高了艾滋病毒知识分数，特别是在了解病毒载量和CD 4检测结果的含义和重要性方面。这项试点研究的结果表明，有希望增加基本的预防母婴传播服务与辅导母亲和文化适应的社区倡议可以有效地传达信息，并在改善情绪前景和艾滋病毒阳性的孕妇在南非。
Nearly 30% of pregnant women in South Africa are estimated to be HIV seropositive, yet adherence to guidelines for the prevention of mother-to-child transmission of HIV (PMTCT) is often low. A pilot study was developed to see whether PMTCT services provided by the South African Government could be enhanced by the Mamekhaya program, a combination of the mothers2mothers peer-mentoring program and a culturally adapted cognitive-behavioral intervention (CBI) from the USA. Pregnant women attending two maternity clinics offering PMTCT in Gugulethu and Vanguard Townships, Cape Town, South Africa, were invited to participate in the study. Women at the intervention site (Gugulethu) received the support of a mentor mother and also attended an eight-session Mamekhaya CBI. At the control site (Vanguard), women received standard services provided by midwives and counselors. Baseline assessments were completed by all participants at enrollment (n=160), and follow-ups were completed six months later by 44% of participants. Self-reports of adherence to PMTCT practices were high across both sites (90% or more engaging in the core practices). Women at the Mamekhaya site showed significantly greater improvement in establishing social support and reducing depression scores than women at the control site. Mamekhaya participants also showed trends for better attendance at follow-up medical visits, and greater improvements in positive coping. The greatest effect of the Mamekhaya program was to increase HIV knowledge scores, particularly with regard to understanding the meaning and importance of viral load and CD4 test results. Results from this pilot study show promise that augmenting basic PMTCT services with mentor mothers and a culturally adapted CBI can be effective in conveying information and in improving the emotional outlook and hopefulness of HIV-positive pregnant women in South Africa.