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A Systematic Review of Behavioral Couples-Based Interventions Targeting Prevention of Mother-to-Child Transmission in Low- and Middle-Income Countries.
AIDS and Behavior ( IF 4.852 ) Pub Date : 2021-08-20 , DOI: 10.1007/s10461-021-03401-x
Karen Hampanda 1, 2 , Krysta Pelowich 2 , Benjamin H Chi 3 , Lynae A Darbes 4 , Janet M Turan 5 , Wilbroad Mutale 6 , Lisa Abuogi 2, 7
Affiliation  

There is increasing focus in HIV prevention and treatment on couples-based approaches. No systematic review has synthesized prospective behavioral couples-based HIV trials targeting prevention of mother-to-child transmission (PMTCT) outcomes in low- and middle-income countries (LMICs). We systematically reviewed published abstracts and articles reporting prospective comparative evaluations of behavioral couples-based HIV interventions delivered during pregnancy to both members of a self-identified heterosexual couple in LMICs following PRISMA. Citations, abstracts, and full texts were double screened for eligibility. References meeting eligibility criteria underwent double data abstraction, quality appraisal, and qualitative synthesis. We identified 295 unique publications. Of these, 5 randomized trials were deemed eligible and synthesized. Studies were conducted in 3 different African countries using three overarching intervention approaches: home-based; group workshops; and faith-based. Studies included various PMTCT outcome measures. We found evidence that behavioral couples-based approaches around the time of pregnancy can positively affect HIV testing among pregnant women and their male partners, infant HIV prophylaxis use, and HIV-free infant survival. The effects on other PMTCT outcomes were not well supported. There was a low to moderate risk of bias among the included studies. Few couples-based PMTCT interventions have been tested in LMICs. Of the interventions we located, workshops/group education and home-based couple counseling and testing were most commonly used to promote PMTCT. Research is needed on the role of relationship dynamics within such interventions and whether couples-based approaches during pregnancy can extend to health outcomes across the PMTCT continuum of care.

中文翻译:

对中低收入国家预防母婴传播的基于行为伴侣的干预措施的系统评价。

艾滋病预防和治疗越来越关注以夫妻为基础的方法。没有系统评价综合了针对低收入和中等收入国家 (LMIC) 预防母婴传播 (PMTCT) 结果的前瞻性行为伴侣 HIV 试验。我们系统地回顾了已发表的摘要和文章,这些文章报告了在 PRISMA 之后对中低收入国家中自我认同的异性恋夫妇在怀孕期间进行的基于行为夫妇的 HIV 干预措施的前瞻性比较评估。对引文、摘要和全文进行了双重筛选以符合资格。符合资格标准的参考文献经过双重数据提取、质量评估和定性综合。我们确定了 295 篇独特的出版物。其中,5 项随机试验被认为符合条件并被综合。使用三种总体干预方法在 3 个不同的非洲国家进行了研究:以家庭为基础;小组研讨会;并以信仰为基础。研究包括各种 PMTCT 结果测量。我们发现证据表明,在怀孕期间基于行为伴侣的方法可以对孕妇及其男性伴侣的 HIV 检测、婴儿 HIV 预防措施的使用和无 HIV 婴儿的存活率产生积极影响。对其他 PMTCT 结果的影响没有得到很好的支持。在纳入的研究中存在低至中等偏倚风险。很少有基于夫妻的 PMTCT 干预措施在 LMICs 中进行过测试。在我们找到的干预措施中,研讨会/小组教育和家庭夫妻咨询和测试最常用于促进 PMTCT。
更新日期:2021-08-20
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