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Pregnancy is an Ideal Time for HIV-Prevention, Study Finds
An HIV-prevention program targeted at women receiving prenatal care appears to be an effective way of reducing risks for HIV, sexually transmitted infections (STIs) and unplanned future pregnancies, a new study has found. Researchers led by Trace Kershaw and Jeannette Ickovics, faculty at the Yale School of Public Health and the Center for Interdisciplinary Research on AIDS at Yale University, examined the effects of group prenatal care that included an HIV-prevention component (known as CenteringPregnancy Plus) to determine if reductions in STIs, repeat pregnancy and sexual risk behavior could be documented among young women at highest risk. The study group consisted of women 14-25 years old and found that those in the CenteringPregnancy Plusgroup prenatal care were 51 percent less likely to become pregnant again six months after delivery than their peers in control groups. Such repeat pregnancies can have an adverse impact on young mothers and their ability to care for their children. Furthermore, women in the prevention group also reported increased condom use, decreased unprotected sexual intercourse and, for adolescents, a reduction in the incidence of STIs—9 percent vs. 17 percent—compared with adolescents in the control. “This intervention is different from other HIV interventions because it integrates sexual risk prevention into the existing structure of prenatal care,” said Kershaw. “By doing this we capitalize on women’s motivations for a healthy pregnancy and their frequent contact with care providers.” The study followed 1,047 women at two health centers (one in Atlanta; the other in New Haven) from early pregnancy through one-year postpartum. The intervention provided comprehensive prenatal care in a group setting along with self-care activities, safe-sex goal setting, discussions about condom use and development of partner communication skills about safe sex. “Pregnancy may be an important window of opportunity to promote changes in behavior and improve the health of women. This study shows that we can create integrated programs that positively influence a wide range of health domains instead of dealing with each health problem in isolation. Furthermore, our results should impact the design and delivery of future prenatal care services,” said Ickovics. Ickovics and Kershaw are conducting follow-up research that includes an NIH-funded study in 14 New York City community hospitals and health centers to evaluate individual and practice-level effects as well as cost effectiveness. Details of the study appeared this week in the online version of the American Journal of Public Health. Researchers from the Yale School of Medicine, Emory University and the Centering Healthcare Institute also participated in the study. ~Story by Michael Greenwood |
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