Pilot Implementation-Effectiveness Study of an Enhanced Mentor Mother Strategy for Pregnant and Postpartum Women Living With HIV

What this Trial Is About

This research aims to evaluate an enhanced Mentor Mother (MM) strategy that provides risk-based, differentiated prevention of mother-to-child transmission of HIV (PMTCT) services to pregnant and postpartum women living with HIV (WLHIV) and their infants. The study will take place at Burnt Forest Sub-District Hospital in Kenya and will assess whether the enhanced MM approach can be delivered as planned and accepted by patients and staff, while also examining its impact on key clinical outcomes such as retention in care, viral suppression, infant HIV testing, and prevention of HIV transmission to infants. Participants will receive support from trained Mentor Mothers who will use a structured tool to assess maternal and infant risk at each clinic visit. Based on identified risks like HIV viremia, stigma, non-disclosure, and socioeconomic barriers, MMs will provide tailored counseling, navigation, outreach, and referrals. Women without identified risks will receive a streamlined support package. This enhanced MM strategy is integrated into routine antenatal and postnatal care and builds on national differentiated service delivery guidelines. Women choosing to participate will meet with a Mentor Mother during their regular clinic visits over a 15-month implementation period. Researchers will monitor fidelity, feasibility, and acceptability of the enhanced MM strategy using checklists, audits, observations, satisfaction surveys, and focus groups. Clinical outcomes such as maternal retention, viral suppression, infant HIV testing uptake, and HIV transmission rates will be assessed before and after the intervention and compared to similar clinics using standard MM services.

Enhanced Mentor Mother Strategy for Pregnant and Postpartum Women Living With HIV