Pregnancy as a Window of Opportunity for HIV Prevention: Effects of an HIV Intervention Delivered Within Prenatal Care.

• Autores: Trace S. Kershaw, Urania Magriples, Claire M Westdahl, Sharon Schindler Rising, Jeannette R Ickovics
• Localización: American journal of public health, ISSN 0090-0036, Vol. 99, Nº. 11, 2009, págs. 2079-2086
• Idioma: inglés
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• Resumen

  • Objectives. We sought to determine whether an HIV prevention program bundled with group prenatal care reduced sexually transmitted infection (STI) incidence, repeat pregnancy, sexual risk behavior, and psychosocial risks. Methods. We conducted a randomized controlled trial at 2 prenatal clinics. We assigned pregnant women aged 14 to 25 years (N=1047) to individual care, attention-matched group care, and group care with an integrated HIV component. We conducted structured interviews at baseline (second trimester), third trimester, and 6 and 12 months postpartum. Results. Mean age of participants was 20.4 years; 80% were African American. According to intent-to-treat analyses, women assigned to the HIV-prevention group intervention were significantly less likely to have repeat pregnancy at 6 months postpartum than individual-care and attention-matched controls; they demonstrated increased condom use and decreased unprotected sexual intercourse compared with individual-care and attention-matched controls. Sub-analyses showed that being in the HIV-prevention group reduced STI incidence among the subgroup of adolescents. Conclusion. HIV prevention integrated with prenatal care resulted in reduced biological, behavioral, and psychosocial risks for HIV. (Am J Public Health. 2009; 99:2079-2086. doi:10.2105/AJPH.2008.154476) [ABSTRACT FROM AUTHOR]