ADHERENCE TO HIV TREATMENT POSTPARTUM: THE IMPLICATIONS OF TRANSITIONS AMONG WOMEN LIVING WITH HIV IN SOUTH AFRICA

K01 MH112443 (Pellowski)

Prevention of mother-to-child transmission (PMTCT) efforts have reduced the rates of vertical transmission to 2.7%, however, optimal antiretroviral therapy (ART) adherence remains a difficult goal to reach, particularly postpartum. The contribution of the proposed research is expected to be two-fold: 1) to gain an understanding of how influential contextual, interpersonal, clinic, and individual level factors change during key moments of transition during pregnancy and postpartum and influence ART adherence and 2) to develop bio-behavioral interventions to assist mothers in maintaining their adherence to ART postpartum. To accomplish these goals, this 5-year career development award is comprised of two studies:

Pregnancy, Adherence, and Motherhood (PAM) Study 

The PAM study is a longitudinal qualitative cohort study that was conducted between 2018-2019 in Cape Town, South Africa. Pregnant women living with HIV were recruited during late pregnancy and were interviewed at 4 time points through 1 year postpartum. The overarching goal of this study was to understand women’s experiences of the transition from pregnancy to postpartum and how changes inherent in this transition impacted their adherence to HIV treatment postpartum. Data from this study is currently being analyzed and publications are forthcoming.

Womandla Health RCT

Drawing on formative data from the PAM Study, we developed the Womandla Health behavioral intervention which aims to support women living with HIV through the transition from pregnancy to postpartum. This intervention model employs a community health worker model in addition to Motivational Interviewing to guide women through 4 counseling sessions that focus on being a strong mother and boosting women’s confidence to achieve their goals for the postpartum period. We are currently testing this intervention in a randomized controlled trial in Gugulethu, Cape Town, SA; this study is currently enrolling participants: ClinicalTrials.gov Identifier: NCT04846569