Our Choice” improves use of safer conception methods among HIV serodiscordant couples in Uganda: a cluster randomized controlled trial evaluating two implementation approaches

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dc.contributor.authorWagner, Glenn J.
dc.contributor.authorWanyenze, Rhoda K.
dc.contributor.authorBeyeza-Kashesya, Jolly
dc.contributor.authorGwokyalya, Violet
dc.contributor.authorHurley, Emily
dc.contributor.authorMindry, Deborah
dc.contributor.authorFinocchario-Kessler, Sarah
dc.contributor.authorNanfuka, Mastula
dc.contributor.authorTebeka, Mahlet G.
dc.contributor.authorSaya, Uzaib
dc.contributor.authorBooth, Marika
dc.contributor.authorGhosh-Dastidar, Bonnie
dc.contributor.authorLinnemayr, Sebastian
dc.contributor.authorStaggs, Vincent S.
dc.contributor.authorGoggin, Kathy
dc.date.accessioned2022-02-15T13:39:45Z
dc.date.available2022-02-15T13:39:45Z
dc.date.issued2021
dc.description.abstractSafer conception counseling (SCC) to promote the use of safer conception methods (SCM) is not yet part of routine family planning or HIV care. Guidelines for the use of SCM have been published, but to date there are no published controlled evaluations of SCC. Furthermore, it is unknown whether standard methods commonly used in resource constrained settings to integrate new services would be sufficient, or if enhanced training and supervision would result in a more efficacious approach to implementing SCC. Methods: In a hybrid, cluster randomized controlled trial, six HIV clinics were randomly assigned to implement the SCC intervention Our Choice using either a high (SCC1) or low intensity (SCC2) approach (differentiated by amount of training and supervision), or existing family planning services (usual care). Three hundred eighty-nine HIV clients considering childbearing with an HIV-negative partner enrolled. The primary outcome was self-reported use of appropriate reproductive method (SCM if trying to conceive; modern contraceptives if not) over 12 months or until pregnancy. Results: The combined intervention groups used appropriate reproductive methods more than usual care [20.8% vs. 6.9%; adjusted OR (95% CI)=10.63 (2.79, 40.49)], and SCC1 reported a higher rate than SCC2 [27.1% vs. 14.6%; OR (95% CI)=4.50 (1.44, 14.01)]. Among those trying to conceive, the intervention arms reported greater accurate use of SCM compared to usual care [24.1% vs. 0%; OR (95% CI)=91.84 (4.94, 1709.0)], and SCC1 performed better than SCC2 [34.6% vs. 11.5%; OR (95% CI)=6.43 (1.90, 21.73)]. The arms did not vary on modern contraception use among those not trying to conceive. A cost of $631 per person was estimated to obtain accurate use of SCM in SCC1, compared to $1014 in SCC2en_US
dc.identifier.citationWagner, G. J., Wanyenze, R. K., Beyeza-Kashesya, J., Gwokyalya, V., Hurley, E., Mindry, D., ... & Goggin, K. (2021). “Our Choice” improves use of safer conception methods among HIV serodiscordant couples in Uganda: a cluster randomized controlled trial evaluating two implementation approaches. Implementation Science, 16(1), 1-13.en_US
dc.identifier.urihttps://doi.org/10.1186/s13012-021-01109-z
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2151
dc.language.isoenen_US
dc.publisherImplementation Scienceen_US
dc.subjectHIVen_US
dc.subjectSafer conception counselingen_US
dc.subjectContraceptionen_US
dc.subjectFamily planningen_US
dc.subjectUgandaen_US
dc.subjectSerodiscordant couplesen_US
dc.titleOur Choice” improves use of safer conception methods among HIV serodiscordant couples in Uganda: a cluster randomized controlled trial evaluating two implementation approachesen_US
dc.typeArticleen_US
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