Cluster-Randomized Controlled Study of SMS Text Messages for Prevention of Mother-to-Child Transmission of HIV in Rural Kenya.
Cluster-Randomized Controlled Study of SMS Text Messages for Prevention of Mother-to-Child Transmission of HIV in Rural Kenya.
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DOI：
10.1155/2016/1289328
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发表时间：
2016
影响因子：
1.7
通讯作者：
Machekano R
中科院分区：
文献类型：
--
作者：
Kassaye SG;Ong'ech J;Sirengo M;Kose J;Matu L;McOdida P;Simiyu R;Syengo T;Muthama D;Machekano R
背景抗逆转录病毒药物是预防艾滋病毒母婴传播（PMTCT）的关键，而传播减缓受到服务提供、坚持和保留的影响。方法.我们在肯尼亚尼扬扎的26个机构进行了一项随机分组对照研究，以确定短信对预防母婴传播结局的有效性。使用STATA在设施水平估计相对风险和置信区间。结果2012年6月至2013年7月，550名妇女参加了研究。中位年龄为25.6岁，85.3%接受了抗逆转录病毒药物治疗。干预组和对照组的母亲抗逆转录病毒药物使用情况相似：妊娠34-36周时分别为254/261（97.3%）和241/242（99.6%），分娩时分别为234/247（94.7%）和229/229（100%）。在婴儿中，199/246（80.9%）和209/232（90.1%）接受了抗逆转录病毒药物治疗（RR：0.91; 95% CI：0.77-1.14）; 88%和88.6%的婴儿在6周时接受了艾滋病毒检测，干预组和对照组分别有1/243（0.4%）和3/217（1.4%）例阳性结果。干预组和对照组的交流均有所增加，平均数为7.5（SD：5.70），而对照组为6（SD：9.96），p < 0.0001。结论.我们确定了高抗逆转录病毒药物摄入和婴儿艾滋病毒检测，艾滋病毒传播非常低。增加沟通可能会影响寻求健康的行为，无论技术如何。需要检验促进交流对防止母婴传播成果的长期有效性。该研究已在ClinicalTrials.gov上注册，标识符为NCT 01645865。
Background. Antiretroviral medications are key for prevention of mother-to-child transmission (PMTCT) of HIV, and transmission mitigation is affected by service delivery, adherence, and retention. Methods. We conducted a cluster-randomized controlled study in 26 facilities in Nyanza, Kenya, to determine the efficacy of SMS text messages on PMTCT outcomes. The relative risk and confidence intervals were estimated at the facility level using STATA. Results. 550 women were enrolled, from June 2012 to July 2013. The median age was 25.6 years, and 85.3% received ARVs. Maternal ARV use was similar between the intervention and control arms: 254/261 (97.3%) versus 241/242 (99.6%) at 34–36 weeks of gestation and 234/247 (94.7%) versus 229/229 (100%) at delivery. Among infants, 199/246 (80.9%) and 209/232 (90.1%) received ARVs (RR: 0.91; 95% CI: 0.77–1.14); 88% versus 88.6% were tested for HIV at 6 weeks, with 1/243 (0.4%) and 3/217 (1.4%) positive results in the intervention and control arms, respectively. Communication increased in both the intervention and control arms, with the mean number of 7.5 (SD: 5.70) compared with 6 (SD: 9.96), p < 0.0001. Conclusions. We identified high ARV uptake and infant HIV testing, with very low HIV transmission. Increased communication may influence health-seeking behaviors irrespective of technology. The long-term effectiveness of facilitated communication on PMTCT outcomes needs to be tested. The study has been registered on ClinicalTrials.gov under the identifier NCT01645865.