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Peer-mother counseling improves HIV treatment adherence and status disclosure over time among pregnant and postpartum women in rural Uganda

Year: 2025

Type: article

Abstract: Adherence to antiretroviral therapy (ART) and disclosure of HIV status are critical for achieving HIV viral suppression and eliminating perinatal transmission of HIV. The ENHANCED-SPS intervention was designed to address barriers to viral suppression among pregnant and postpartum women with HIV and included standardized support and counseling though phone calls by peer-mothers. Using targeted minimum loss-based estimation (TMLE), we evaluated changes in adherence ($\le$1 dose of ART missed per month) and HIV status disclosure (to anyone and to a spouse or partner) among 505 pregnant and postpartum women with HIV who received the ENHANCED-SPS intervention in rural Uganda (2019-2021). ART adherence was 68% (95% CI, 62-74) at baseline and increased to 93% (95% CI, 81-100) after 12 months, corresponding to a 25% increase (95% CI, 9-40; P = .009). Largest improvements were among participants who were aged 15-24 years, breastfeeding, or without viral suppression at enrollment. At baseline, 80% (95% CI, 69-90) had disclosed their HIV status to anyone—increasing to 94% (95% CI, 89-99) after 12 months and corresponding to a 14% improvement (95% CI, 8-21; P = .003). Similar trends were observed for disclosure to a spouse or partner. Among pregnant and postpartum women with HIV in rural Uganda, the ENHANCED-SPS intervention was associated with meaningful improvements in ART adherence and HIV status disclosure after 1 year.

Source: AJE Advances Research in Epidemiology

DOI: 10.1093/ajeadv/uuaf002