2250. Assessing the Acceptability of a Community-Based Intervention to Improve the Continuum of Care of Postpartum Women Living with HIV
Session: Poster Abstract Session: HIV: Pediatrics
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • IDWeek Poster.pdf (248.6 kB)
  • Background: Many women living with HIV (WLWH) fall out of the care continuum after delivery. Existing evidence-based interventions are aimed at increasing retention of WLWH outside the perinatal period but none, in the US, focus on improving retention postpartum. mothers2mothers (m2m) is a peer mentor mother program developed in South Africa and successfully implemented in six African countries, with evidence of increased self-efficacy and retention in HIV care postpartum. Here, we assess the acceptability of an adapted version of m2m in the US.

    Methods: In depth interviews were conducted with five pregnant and four postpartum WLWH receiving prenatal and HIV care in a Philadelphia clinic, to assess barriers and facilitators to retention in HIV care during pregnancy and postpartum. We also assessed participants’ acceptability of m2m with the goal to adapt the program to meet their needs. All interviews were audio-taped, transcribed and analyzed. Codes were developed and applied to all transcripts and matrices were used to facilitate comparisons across different types of participants.

    Results: Participants included low-income Black and Hispanic women with a mean age was 35 (range 23-42). Regardless of their stage in the care continuum, women found m2m to be an acceptable intervention to help sustain engagement in care after delivery and discussed ways to tailor the program to fit their needs. Participants reported experiencing trauma related to interpersonal violence and conflicts, stigma from HIV or HIV disclosure, and struggles with substance use. Many experienced depression or had a history of suicidal ideation or attempt. An overarching finding was that women’s strongest motivator for staying in care was to protect the health and well-being of their baby. In addition, the majority of women found that family support, especially from their mothers, enhanced their coping skills, and in turn, facilitated their retention in care.

    Conclusion: m2m is a promising intervention with the potential to improve the care continuum of WLWH who are pregnant or postpartum. The program will need to be adapted using a trauma informed approach to meet the needs of WLWH. Messaging will need to maximize on maternal support and women’s motivation to keep their infant healthy to leverage retention in care postpartum.

    Yetunde Akinde, MPH1, Hervette Nkwihoreze, MPH1, Erika Aaron, RN, CRNP, MSN2, Allison Groves, PhD, MHS3, Gregg Alleyne, MD4 and Florence Momplaisir, MD MSHP5, (1)Drexel University College of Medicine, Philadelphia, PA, (2)Drexel University, Philadelphia, PA, (3)Drexel University Dornsife School of Public Health, Philadelphia, PA, (4)OB/GYN Generalist, Drexel University, Philadelphia, PA, (5)Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA

    Disclosures:

    Y. Akinde, None

    H. Nkwihoreze, None

    E. Aaron, None

    A. Groves, None

    G. Alleyne, None

    F. Momplaisir, None

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