OBJECTIVES: To evaluate the impact of family planning promotion on incident pregnancy in a combined effort to address Prongs 1 and 2 of prevention of mother-to-child transmission of HIV. DESIGN: We conducted a factorial randomized controlled trial of 2 video-based interventions. METHODS: "Methods" and "Motivational" messages promoted long-term contraceptive use among 1060 couples with HIV in Lusaka, Zambia. RESULTS: Among couples not using contraception before randomization (n = 782), the video interventions had no impact on incident pregnancy. Among baseline contraceptive users, viewing the "Methods video" which focused on the intrauterine device and contraceptive implant was associated with a significantly lower pregnancy incidence [hazard ratio (HR) = 0.38; 95% confidence interval (CI): 0.19 to 0.75] relative to those viewing control and/or motivational videos. The effect was strongest in concordant positive couples (HR = 0.22; 95% CI: 0.08 to 0.58) and couples with HIV-positive women (HR = 0.23; 95% CI: 0.09 to 0.55). CONCLUSIONS: The "Methods video" intervention was previously shown to increase uptake of long-acting contraception and to prompt a shift from daily oral contraceptives to quarterly injectables and long-acting methods such as the intrauterine device and implant. Follow-up confirms sustained intervention impact on pregnancy incidence among baseline contraceptive users, in particular couples with HIV-positive women. Further work is needed to identify effective interventions to promote long-acting contraception among couples who have not yet adopted modern methods.
RCT Entities:
OBJECTIVES: To evaluate the impact of family planning promotion on incident pregnancy in a combined effort to address Prongs 1 and 2 of prevention of mother-to-child transmission of HIV. DESIGN: We conducted a factorial randomized controlled trial of 2 video-based interventions. METHODS: "Methods" and "Motivational" messages promoted long-term contraceptive use among 1060 couples with HIV in Lusaka, Zambia. RESULTS: Among couples not using contraception before randomization (n = 782), the video interventions had no impact on incident pregnancy. Among baseline contraceptive users, viewing the "Methods video" which focused on the intrauterine device and contraceptive implant was associated with a significantly lower pregnancy incidence [hazard ratio (HR) = 0.38; 95% confidence interval (CI): 0.19 to 0.75] relative to those viewing control and/or motivational videos. The effect was strongest in concordant positive couples (HR = 0.22; 95% CI: 0.08 to 0.58) and couples with HIV-positive women (HR = 0.23; 95% CI: 0.09 to 0.55). CONCLUSIONS: The "Methods video" intervention was previously shown to increase uptake of long-acting contraception and to prompt a shift from daily oral contraceptives to quarterly injectables and long-acting methods such as the intrauterine device and implant. Follow-up confirms sustained intervention impact on pregnancy incidence among baseline contraceptive users, in particular couples with HIV-positive women. Further work is needed to identify effective interventions to promote long-acting contraception among couples who have not yet adopted modern methods.
Authors: Kristin M Wall; William Kilembe; Bellington Vwalika; Lisa B Haddad; Naw Htee Khu; Ilene Brill; Udodirim Onwubiko; Elwyn Chomba; Amanda Tichacek; Susan Allen Journal: J Womens Health (Larchmt) Date: 2017-08 Impact factor: 2.681
Authors: Catherine S Todd; Tracy C Anderman; Sarah Long; Landon Myer; Linda-Gail Bekker; Gregory A Petro; Heidi E Jones Journal: Contraception Date: 2018-02-09 Impact factor: 3.375
Authors: Rena C Patel; Beatrice Jakait; Katherine Thomas; Constantin Yiannoutsos; Maricianah Onono; Elizabeth A Bukusi; Kara K Wools-Kaloustian; Craig R Cohen Journal: Contraception Date: 2019-06-24 Impact factor: 3.375
Authors: Lisa B Haddad; Caryl Feldacker; Denise J Jamieson; Hannock Tweya; Carrie Cwiak; Amy G Bryant; Mina C Hosseinipour; Thomas Chaweza; Linly Mlundira; Fanny Kachale; Gretchen S Stuart; Irving Hoffman; Sam Phiri Journal: Int J Gynaecol Obstet Date: 2014-05-13 Impact factor: 3.561
Authors: Lisa Haddad; Kristin M Wall; Bellington Vwalika; Naw Htee Khu; Ilene Brill; William Kilembe; Rob Stephenson; Elwyn Chomba; Cheswa Vwalika; Amanda Tichacek; Susan Allen Journal: AIDS Date: 2013-10 Impact factor: 4.177