Randomized controlled trial to test the RHANI Wives HIV intervention for women in India at risk for HIV from husbands.
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SUBMITTER: Raj A
PROVIDER: S-EPMC4058338 | biostudies-literature | 2013 Nov
REPOSITORIES: biostudies-literature
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Randomized controlled trial to test the RHANI Wives HIV intervention for women in India at risk for HIV from husbands.
Raj Anita A Saggurti Niranjan N Battala Madhusudana M Nair Saritha S Dasgupta Anindita A Naik D D DD Abramovitz Daniela D Silverman Jay G JG Balaiah Donta D
AIDS and behavior 20131101 9
This study involved evaluation of the short-term impact of the RHANI Wives HIV intervention among wives at risk for HIV from husbands in Mumbai, India. A two-armed cluster RCT was conducted with 220 women surveyed on marital sex at baseline and 4-5 month follow-up. RHANI Wives was a multisession intervention focused on safer sex, marital communication, gender inequities and violence; control participants received basic HIV prevention education. Generalized linear mixed models were conducted to a ...[more]
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Project description:BackgroundPrimiparous women experience various challenges if not provided with social support in the early postpartum period. Support in form of postpartum education programs is needed to improve mental well-being in primiparous women. The aim of this study was to determine the effect of a postnatal supportive education program for husbands on the perceived social support (primary outcome), and stress and maternal self-efficacy (secondary outcome) of their primiparous wives.MethodsThis randomized clinical trial was performed on pregnant women referring to healthcare centers for routine care from September to November 2021 in Kermanshah, Iran. One hundred pregnant women were randomly divided in to intervention and control groups. Four 45-90 min online training sessions were held weekly for the husbands of the intervention group. The primiparous women completed the Postpartum Partner Support Scale, Perceived Stress Scale, and Postpartum Parental Expectations Survey before (third day after delivery, immediately and one month after completing the intervention. Data were analyzed using Fisher's exact test, Chi-square test, independent t-test, and repeated measures analysis of variance in SPSS version 24, and p < 0.05 was considered statistically significant.ResultsIn the control and intervention groups before the intervention, socio-demographic characteristics (P > 0.05), the mean scores of perceived social support (P = 0.11), maternal self-efficacy (p = 0.37) and perceived stress (p = 0.19) were not statistically significant. However, in the intervention group compared to the control group the mean scores of perceived social support (79.42 ± 7.17 vs. 37.26 ± 7.99, P < 0.001), maternal self-efficacy (186.22 ± 39.53 vs. 106.3 ± 32.88, P < 0.001) and perceived stress (16.36 ± 6.65 vs. 43.3 ± 7.39, P < 0.001) immediately after the intervention and the mean scores of perceived social support (84.4 ± 5.91 vs. 37.14 ± 6.63, P < 0.001), maternal self-efficacy (191.24 ± 38.92 vs. 112.34 ± 37.12, P < 0.001) and perceived stress (13.98 ± 4.84 vs. 39.06 ± 7.25, P < 0.001) one month after the intervention changed significantly.ConclusionThe postpartum supportive education program for husbands was effective in promoting social support for primiparous women. Thus it can be introduced as routine care in the postpartum period.Trial registrationClinical trial registration Iranian Registry of Clinical Trials; https://en.irct.ir/user/trial/56451/view (IRCT20160427027633N8), registered (15/06/2021).
| S-EPMC10045875 | biostudies-literature
Project description:ObjectiveTo assess the impact of nurse-led Asha (Accredited Social Health Activist)-support behavioral and nutritional intervention among women living with HIV/AIDS (WLH/A) in rural India.DesignCluster randomized controlled trial.MethodsSixteen Primary Health Centers serving WLH/A in Andhra Pradesh were grouped into four regional clusters that were randomly allocated into one of four arms. All four groups included Asha-support and consisted of: Asha-support only (control group); nutrition education; nutrition supplementation; and the combination of supplementation and education. Differences between baseline and 6-month follow-up for key physiological outcomes (BMI, CD4 cell count) were analyzed using factorial mixed models that accounted for geographic clustering.ResultsAt 6 months, all groups improved CD4 cell count: Asha only [mean difference score (D) = 343.97, standard deviation (SD) = 106.94], nutrition education (D = 356.15, SD = 0.69), nutrition supplement (D = 469.66, SD = 116.0), and nutrition supplement and education (D = 530.82, SD = 128.56). In multivariable models, Asha-support and nutrition, and Asha-support and nutrition supplement interventions demonstrated independent significant improvements in CD4 cell count; the interaction term was significant [estimate = 529.9; 95% confidence interval (CI) 512.0, 547.8; P = 0.006]. BMI also increased for all groups: Asha only (D = 0.95, SD = 0.82), Asha and nutrition education (D = 1.28, SD = 0.53), Asha and nutrition supplement (D = 2.38, SD = 0.60), nutrition supplement, and nutrition supplement and education (D = 2.72, SD = 0.84). Nutrition supplementation and nutrition education demonstrated independent effects on BMI; the interaction term was not significant (estimate = 0.27; 95% CI = 2.5, 2.7; P = 0.80).ConclusionInterventions supported by community workers were efficacious at improving physiological outcomes and may be beneficial at meeting critical healthcare needs of vulnerable WLH/A in India.
| S-EPMC6361536 | biostudies-literature
Project description:We examined the effects of an aerobic exercise intervention on adiposity outcomes that may be involved in the association between physical activity and breast cancer risk.This study was a two-centre, two-armed, randomized controlled trial. The 1-year-long exercise intervention included 45 min of moderate-to-vigorous aerobic exercise five times per week, with at least three of the sessions being facility based. The control group was asked not to change their activity and both groups were asked not to change their diet.A total of 320 postmenopausal, sedentary, normal weight-to-obese women aged 50-74 years who were cancer-free, nondiabetic and nonhormone replacement therapy users were included in this study.Anthropometric measurements of height, weight and waist and hip circumferences; dual energy X-ray absorptiometry measurements of total body fat; and computerized tomography measurements of abdominal adiposity were carried out.Women in the exercise group exercised a mean of 3.6 days (s.d.=1.3) per week and 178.5 min (s.d.=76.1) per week. Changes in all measures of adiposity favored exercisers relative to controls (P<0.001). The mean difference between groups was: -1.8 kg for body weight; -2.0 kg for total body fat; -14.9 cm(2) for intra-abdominal fat area; and -24.1 cm(2) for subcutaneous abdominal fat area. A linear trend of greater body fat loss with increasing volume of exercise was also observed.A 1-year aerobic exercise program consistent with current public health guidelines resulted in reduced adiposity levels in previously sedentary postmenopausal women at higher risk of breast cancer.
| S-EPMC3061001 | biostudies-other
Project description:OBJECTIVE:Hazardous alcohol use by HIV-infected women is associated with poor HIV outcomes and HIV transmission risk behaviors. We examined the effectiveness of brief alcohol intervention (BI) among hazardous drinking women receiving care in an urban HIV clinic. METHODS:Women were randomized to a 2-session BI or usual care. Outcomes assessed at baseline, 3, 6, and 12 months included 90-day frequency of any alcohol use and heavy/binge drinking (?4 drinks per occasion), and average drinks per drinking episode. Secondary outcomes included HIV medication and appointment adherence, HIV-1 RNA suppression, and days of unprotected vaginal sex. We examined intervention effectiveness using generalized mixed-effect models and quantile regression. RESULTS:Of 148 eligible women, 74 were randomized to each arm. In mixed-effects models, 90-day drinking frequency decreased among intervention group compared with control, with women in the intervention condition less likely to have a drinking day (odds ratio: 0.42; 95% confidence interval: 0.23 to 0.75). Heavy/binge drinking days and drinks per drinking day did not differ significantly between groups. Quantile regression demonstrated a decrease in drinking frequency in the middle to upper ranges of the distribution of drinking days and heavy/binge drinking days that differed significantly between intervention and control conditions. At follow-up, the intervention group had significantly fewer episodes of unprotected vaginal sex. No intervention effects were observed for other outcomes. CONCLUSIONS:BI reduces frequency of alcohol use and unprotected vaginal sex among HIV-infected women. More intensive services may be needed to lower drinks per drinking day and enhance care for more severely affected drinkers.
| S-EPMC4634011 | biostudies-literature
Project description:BackgroundPeople living with HIV in the USA smoke at a rate nearly three times that of the general population, and Black women are disproportionately affected by HIV infection.PurposeThis study was conducted to test the preliminary efficacy of a digital storytelling intervention for smoking cessation in U.S. women living with HIV.MethodsParticipants in the treatment arm viewed a film in which women living with HIV talk about quitting smoking, and those in the control arm viewed an attention-control film in which women talk about living with HIV infection. Participants in both arms received eight weekly video-call counseling sessions focused on smoking cessation and nicotine patches or gum during the same period. Participants were followed on a monthly basis from quit day for 3 months.ResultsOf the 53 participants randomized, four withdrew before receiving any intervention, one dropped out during the intervention, and 48 (90.6%) completed the study. No difference was found in the baseline characteristics between the two arms with the exception that the treatment arm had higher nicotine dependence scores [t(1.51) = 2.30, p = .03] than the control arm. Seven day point-prevalence abstinence rates at 3 month follow-up were not found to differ between the two arms. However, the odds of achieving 3 month prolonged abstinence were four times greater (odds ratio = 4.23, 95% confidence interval = 1.10, 16.23) in the treatment arm than the control arm when the analysis was performed with those (n = 49, 92.5%) who received any part of the allotted intervention.ConclusionsA digital storytelling intervention seems to be a valuable strategy to enhance the effect of conventional tobacco dependence treatment for women living with HIV. However, the underlying mechanism of the effect of digital storytelling necessitates further investigations in a large RCT.Clinical Trials Registration No. NCT03289676.
| S-EPMC7391216 | biostudies-literature
Project description:BACKGROUND:In order improve the quality of birth care and women satisfaction with birthing process it is recommended that every woman should be offered the option to experience labour and childbirth with a companion of her choice. Involving husbands who are decision makers in the household may a play role in reducing maternal mortality which is unacceptably high despite the targeted goal to reduce this mortality up to three quarters as targeted in the MDGs by 2015. This is still addressed in the Sustainable Development Goals (SDGs) of 2015/30. This study aimed to explore the experiences and perceptions of husbands' support of their wives during pregnancy, labour and deliveries in Tanzania. METHODS:Qualitative descriptive study design was employed; involving men aged between 24 and 63?years. Participants were selected purposefully at the clinic and in labour ward of SekouToure Regional Referral Hospital (SRRH). The in-depth interview, guided by semi structured interview guide was used to collect the audio recorded and hand written information. Data were analysed using qualitative content analysis. RESULTS:Nine semi-structured interviews were conducted with husbands of women attended for antenatal care and those came for deliveries. Four themes emerged; Demonstrating care, love and affection, adopting modern life style, observing women's right and meeting social economic difficulties. Husbands' support to their partners is a good behaviour practiced during matrimonial lives. Husbands who support their partners during pregnancy and delivery consider themselves as being modern men as they at home take duties beside their usual tasks to let their wives have adequate time to rest during pregnancy. Poor road infrastructure makes difficult to get transport to the healthcare facility especially when labour is imminent. Also ward infrastructure is not supportive to accommodate husbands when they accompany their wives to the healthcare facility. CONCLUSIONS:The healthcare settings in low income countries need to accommodate men during the routine antenatal and intranatal care for the positive outcome of labour and delivery. Educating men on importance of active involvement in reproductive and child health services is important. Exploratory research should be conducted to understand how education and urbanisation affects men involvement in maternal and child health specifically in the low income countries.
| S-EPMC7011545 | biostudies-literature
Project description:OBJECTIVES:We tested the efficacy of an adapted evidence-based HIV-sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women's Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women. METHODS:We conducted a randomized trial with 521 women aged 18 to 60 years in 2 correctional facilities in North Carolina in 2010 and 2011. Intervention participants attended 8 POWER sessions; control participants received a single standard-of-care STI prevention session. We followed up at 3 and 6 months after release. We examined intervention efficacy with mixed-effects models. RESULTS:POWER participants reported fewer male sexual partners than did control participants at 3 months, although this finding did not reach statistical significance; at 6 months they reported significantly less vaginal intercourse without a condom outside of a monogamous relationship and more condom use with a main male partner. POWER participants also reported significantly fewer condom barriers, and greater HIV knowledge, health-protective communication, and tangible social support. The intervention had no significant effects on incident STIs. CONCLUSIONS:POWER is a behavioral intervention with potential to reduce risk of acquiring or transmitting HIV and STIs among incarcerated women returning to their communities.
| S-EPMC4358199 | biostudies-literature
Project description:BackgroundCrowdsourcing, the process of shifting individual tasks to a large group, may enhance human immunodeficiency virus (HIV) testing interventions. We conducted a noninferiority, randomized controlled trial to compare first-time HIV testing rates among men who have sex with men (MSM) and transgender individuals who received a crowdsourced or a health marketing HIV test promotion video.MethodsSeven hundred twenty-one MSM and transgender participants (≥16 years old, never before tested for HIV) were recruited through 3 Chinese MSM Web portals and randomly assigned to 1 of 2 videos. The crowdsourced video was developed using an open contest and formal transparent judging while the evidence-based health marketing video was designed by experts. Study objectives were to measure HIV test uptake within 3 weeks of watching either HIV test promotion video and cost per new HIV test and diagnosis.ResultsOverall, 624 of 721 (87%) participants from 31 provinces in 217 Chinese cities completed the study. HIV test uptake was similar between the crowdsourced arm (37% [114/307]) and the health marketing arm (35% [111/317]). The estimated difference between the interventions was 2.1% (95% confidence interval, -5.4% to 9.7%). Among those tested, 31% (69/225) reported a new HIV diagnosis. The crowdsourced intervention cost substantially less than the health marketing intervention per first-time HIV test (US$131 vs US$238 per person) and per new HIV diagnosis (US$415 vs US$799 per person).ConclusionsOur nationwide study demonstrates that crowdsourcing may be an effective tool for improving HIV testing messaging campaigns and could increase community engagement in health campaigns.Clinical trials registrationNCT02248558.
| S-EPMC4872295 | biostudies-literature
Project description:OBJECTIVES:Marital satisfaction has an important effect on people's mental health. Due to the increasing average age and life expectancy of Iranian women, obtaining knowledge about sexual aspects of post-menopause women for partners can improve their health and quality of life. This study aimed to determine the effect of education for the husbands regarding menopause on marital satisfaction of their wives. METHODS:This randomized controlled trial was conducted on 100 women aged 45 to 55 years old and their husbands in Yazd in 2014. Subjects were randomly assigned to intervention group (50 couples) and control group (50 couples). The data gathering tools included two questionnaires, the first one contained questions about demographic information of women and men, and the other one was used to assess knowledge and practice in men about menopause and Enrich marital satisfaction. The second questionnaire was applied twice; before intervention and two months after that. In the intervention group an educational program in the form of three 60-minute sessions were conducted using speech, but the control group received no training. Analysis was performed through the statistical SPSS software, paired t-test, t-test and chi-square. RESULTS:In the intervention group, two months after the educational program the knowledge of menopausal health and women's marital satisfaction scores increased significantly (P<0.001). But there was no significant difference in control group. CONCLUSIONS:Training menopausal health to husbands can increase women's marital satisfaction in the period of menopausal transition. Therefore, designing and implementing educational programs for husbands is recommended.
| S-EPMC5432462 | biostudies-literature
Project description:BackgroundTransgender women are disproportionately affected by HIV and are less likely to be optimally engaged in care than other groups because of psychosocial challenges. With community collaboration, we developed Healthy Divas, an individual-level intervention to increase healthcare empowerment and gender affirmation to improve engagement in HIV care. Healthy Divas comprises 6 peer-led individual sessions and one group workshop facilitated by a healthcare provider with expertise in HIV care and transgender health.Setting/methodsTo test the intervention's efficacy, we conducted a randomized controlled clinical trial in San Francisco and Los Angeles among transgender women living with HIV; control was no intervention. Transgender field staff conducted recruitment. Assessments occurred at baseline and 3, 6, 9, and 12 months postrandomization. The primary outcome was engagement in HIV care, defined as the sum of (1) self-reported HIV care provider visit, past 6 months, (2) knowledge of most recent CD4 count, (3) self-reported antiretroviral therapy adherence ≥90%, and (4) self-reported antiretroviral therapy adherence ≥80%.ResultsWe enrolled 278 participants; almost half (46%) were African American/Black and one-third (33%) were Hispanic/Latina. At 6 months, participants in the intervention arm had over twice the odds of being in a higher HIV care engagement category than those in the control arm (aOR = 2.17; 95% CI: 1.06 to 4.45; P = 0.04); there were no significant study arm differences in the outcome at the other time points.ConclusionsThis trial demonstrates the short-term efficacy of an urgently needed behavioral intervention to improve engagement in HIV care among transgender women living with HIV; ongoing intervention may be needed to maintain positive impact over time.Trial registrationClinicaltrials.gov identifier: NCT03081559.
| S-EPMC9259040 | biostudies-literature