Document Type
Article
Publication Date
8-14-2018
Identifier
DOI: 10.1186/s13012-018-0793-y; PMCID: PMC6092849
Abstract
BACKGROUND: About 40% of HIV-positive women in sub-Saharan Africa become pregnant post-diagnosis. Despite about half of their pregnancies being planned, safer conception methods (SCM) are underutilized among serodiscordant couples, partially due to the fact that safer conception counseling (SCC) has not been integrated into routine HIV family planning (FP) services.
METHODS: Our Choice is a comprehensive FP intervention that promotes unbiased childbearing consultations to ensure clients receive SCC or contraception services to achieve their desired reproductive goals. The intervention is theoretically grounded and has demonstrated preliminarily feasibility and acceptance through pilot testing. This three-arm cluster randomized controlled trial compares two implementation strategies for integrating Our Choice into routine FP services vs. usual care. Six sites in Uganda will be randomized to receive either (1) Our Choice intervention with enhanced training and supervision provided by study staff (SCC1), (2) Our Choice intervention implemented by the Ministry of Health's standard approach to disseminating new services (SCC2), or (3) existing FP services (usual care). Our Choice and usual care FP services will be implemented simultaneously over a 30-month period. Sixty clients in serodiscordant relationships who express childbearing desires will be enrolled by a study coordinator at each site (n = 360) and followed for 12 months or post-pregnancy (once, if applicable). Analysis will compare intervention arms (SCC1 and SCC2) to usual care and then to each other (SCC1 vs. SCC2) on the primary outcome of correct use of either SCM (if trying to conceive) or dual contraception (if pregnancy is not desired). Secondary outcomes (i.e., pregnancy, use of prevention of mother-to-child transmission services, condom use, and partner seroconversion) and cost-effectiveness will also be examined.
DISCUSSION: Findings will provide critical information about the success of implementation models of varying intensity for integrating SCC into FP, thereby informing policy and resource allocation within and beyond Uganda.
TRIAL REGISTRATION: NCT03167879 ClinicalTrials.gov, Registered 30 May, 2017.
Journal Title
Implement Sci
Volume
13
Issue
1
MeSH Keywords
Adolescent; Adult; Child; Counseling; Family Planning Services; Female; HIV Infections; Humans; Infectious Disease Transmission, Vertical; Male; Middle Aged; Outcome and Process Assessment, Health Care; Pregnancy; Uganda; Young Adult
Keywords
HIV/AIDS; HIV prevention; Implementation science; Mother-to-child transmission; Pregnancy; Safer conception counseling; Safer conception methods; Serodiscordant; Sexual transmission; Sub-Saharan Africa.
Recommended Citation
Goggin K, Hurley EA, Beyeza-Kashesya J, et al. Study protocol of "Our Choice": a randomized controlled trial of the integration of safer conception counseling to transform HIV family planning services in Uganda. Implement Sci. 2018;13(1):110. Published 2018 Aug 14. doi:10.1186/s13012-018-0793-y
Included in
Community Health and Preventive Medicine Commons, Maternal and Child Health Commons, Public Health Education and Promotion Commons
Comments
Grant support
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Publisher's Link: https://implementationscience.biomedcentral.com/articles/10.1186/s13012-018-0793-y