December 2, 2009
The study team set out to determine if "an HIV prevention program bundled with group prenatal care reduced sexually transmitted infection (STI) incidence, repeat pregnancy, sexual risk behavior and psychosocial risks."
At two prenatal clinics, the researchers conducted a randomized controlled trial. Pregnant women ages 14 to 25 (n=1,047) were assigned to individual care, attention-matched group care, or group care with an integrated HIV component. The team conducted structured interviews at baseline (second trimester), third trimester, and six and 12 months postpartum. Eighty percent of participants were African American; participants' mean age was 20.4 years.
Intent-to-treat analysis showed that, compared to individual-care and attention-matched controls, the women assigned to the HIV prevention group intervention were "significantly less likely" to have a repeat pregnancy at six months postpartum. They also demonstrated increased condom use and decreased unprotected sexual intercourse. In sub-analysis, being in the HIV prevention group reduced STI incidence among adolescents.
"HIV prevention integrated with prenatal care resulted in reduced biological, behavioral, and psychosocial risks for HIV," the authors concluded.
American Journal of Public Health
11.2009; Vol. 99; No. 11: P. 2079-2086; Trace S. Kershaw, PhD; Urania Magriples, MD; Claire Westdahl, CNM, MPH; Sharon Schindler Rising, CNM, MSN; Jeannette Ickovics, PhD
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