Skip to main content

Table 3 Family-centred PMTCT intervention models: Comprehensive Services

From: Family-centred approaches to the prevention of mother to child transmission of HIV

Citation, country, sample size Design Target group Family-centred PMTCT programme components Outcomes Study limitations
[27] Abrams et al, 2007; 8 countries in sub- Saharan Africa and southeast Asia; roughly 12,000 individuals Observational cohort HIV-infected pregnant women and their families As part of the MTCT-Plus Initiative, women receiving prevention of mother to child transmission (PMTCT) services were invited to enrol in MTCT- Plus, a comprehensive HIV care programme, along with their newborn infants, as well as HIV+ family and household members More than 2/3 of index women enrolled their HIV-exposed baby or an HIV-infected family member Retention of participants was very high, with fewer than 600 adults leaving the programme, including 190 reported deaths
More than 2000 infants, 90% of those who reached 18 months, were determined uninfected, and of the 761 infected children enrolled, 65% received highly active antiretroviral therapy (HAART)
The feasibility of linking the different services represented in this model may be hindered in other contexts by factors like resource constraints, human capacity and community preferences
[26] Geddes et al, 2008; South Africa; 2624 women Prospective cohort Families PMTCT integrated into antenatal services
Women were encouraged to bring partners for HIV counselling and testing
Psychological services provided for discordant couples
Cluster of differentiation 4 (CD4) counts measured to determine appropriate form of ART and mode of delivery
Polymerase chain reaction (PCR) test given to HIV-exposed infants; HIV+ babies were enrolled in children's programme
During 18 months, 100% of women attending the clinic received counselling
91% of women and 25% of partners were tested for HIV In 338 cases of maternal HIV+, 70% of live births were by caesarean section and 98% of live babies were given nevirapine; 76% also received azidothymidine.
Of the 81% of babies tested at 6 weeks (via PCR), 2.9% tested positive
May have been subject to selection bias - 11% of mothers lost to follow up
Participants may have been socioeconomically and educationally better off than others who attended public facilities
[28, 29] Mermin, 2005; rural Uganda; more than 6000 family members Prospective cohort Families VCT for HIV extended to more than 6000 family members of HIV+ individuals
Distribution of cotrimoxazole prophylaxis and a home-based water purification systems
Future support for additional home-based delivery of ART for more than 4000 individuals
>95% of family members accepted VCT; 35% of married HIV+ individuals discovered they were living with an HIV- spouse Cotrimoxazole prophylaxis taken by HIV+ individuals was associated with a 46% reduction in mortality The water purification system was associated with a 25% reduction in diarrhoea among persons with HIV Data were acquired mainly from a 2005 conference abstract and therefore have not been subjected to peer review