Community-Based Peer Support to Reduce Alcohol Use and Improve HIV Care in Pregnant Women in South Africa

What this Trial Is About

Researchers are evaluating a peer-led behavioral intervention called Mentor Mothers MM aimed at reducing alcohol use among pregnant and breastfeeding women in South Africa. The study focuses on pregnant and lactating people who use alcohol and may or may not be living with HIV. It addresses the combined risks of alcohol use and HIV, particularly the impact on antiretroviral therapy ART adherence and the prevention of HIV transmission to children. This pilot randomized controlled trial involves 100 pregnant women recruited during antenatal care visits. Participants will be randomly assigned to either the MM intervention group or an enhanced HIV attention control group. The MM group will receive brief motivational interviewing sessions delivered by trained mentor mothers from the community who have experience with PrEP or ART and who reduced or stopped alcohol use during pregnancy. These sessions, lasting 15-20 minutes each, will be conducted over a 6-month period covering pregnancy and postpartum stages. The control group will receive educational counseling on HIV risk and adherence support during similar clinic visits, with both groups receiving urine testing and biofeedback counseling related to HIV prevention and alcohol use. During the 6-month study period, participants will attend multiple sessions integrated into routine antenatal care visits. The study team will assess alcohol use reduction through objective measures like phosphatidylethanol PEth levels and self-reports. They will also monitor PrEP initiation and adherence for those without HIV, as well as ART adherence and viral load in participants living with HIV. The study includes regular counseling, urine testing for tenofovir and alcohol metabolites, and ongoing support to understand the interventions impact on health behaviors throughout pregnancy and postpartum.

Mentor Moms+ Study