Evaluation of HIV-adapted group prenatal care

Abstract Background Efforts to further decrease perinatal transmission of HIV include efforts to improve engagement and retention in prenatal care. Group prenatal care has been shown to have benefits in certain other high risk groups of pregnant women, but has not been previously evaluated in pregnant women living with HIV. Objective This study aims to evaluate changes in HIV knowledge, stigma, social support, depression, self-efficacy, and medication adherence after HIV-adapted group prenatal care Study Design All women living with HIV who presented for prenatal care at ≤ 30 weeks in the Harris Health System (Houston, TX) between September 2013 and December 2017 were offered either group or individual HIV-focused prenatal care. Patients were recruited for the study at their initial prenatal visit. HIV topics including HIV facts, disclosure, medication adherence, safe sex and conception, retention in care, and post-delivery baby testing, were added to the standard CenteringPregnancy curriculum (10 two-hour sessions per pregnancy). Knowledge and attitudes toward factors associated with adherence to HIV treatment regimens (stigma, loneliness, perceived social support and depressive symptoms) were compared on written pre- and post-surveys. Surveys included 58 items derived from validated scales, with Likert and dichotomous responses. McNemar’s test, the Wilcoxon signed rank test, and paired t-tests compared pre- and post-survey responses. Results 190 women living with HIV received prenatal care in the clinic during the study period, 93 (49%) of whom participated in CenteringHIV. Sixty six Centering participants enrolled in the study and 42 of those completed pre- and post-surveys. Among women in the Centering program who completed pre- and post-surveys, significant differences were noted with improved perceived social support from family (p=0.011) and friends (p=0.005), decreased depression (EPDS ≥ 10 43% vs 18%, p Conclusion HIV-focused group prenatal care may positively impact perceived social support and depression scores, factors which are closely associated with antiretroviral adherence and retention in care for pregnant women living with HIV.