Skip to main content

Main menu

  • Home
  • Issues
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • COVID-19 Articles
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Submit Manuscript
  • About
    • About GHSP
    • Editorial Team
    • Editorial Board
    • FAQs
    • Instructions for Reviewers
  • Sign up for Alerts
  • Webinars
    • Local Voices Webinar
    • Connecting Creators and Users of Knowledge
    • Publishing About Programs in GHSP
  • News
    • GHSP Call for Papers
  • Other Useful Sites
    • GH eLearning
    • GHJournal Search

User menu

  • My Alerts

Search

  • Advanced search
Global Health: Science and Practice
  • Other Useful Sites
    • GH eLearning
    • GHJournal Search
  • My Alerts

Global Health: Science and Practice

Dedicated to what works in global health programs

Advanced Search

  • Home
  • Issues
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • COVID-19 Articles
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Submit Manuscript
  • About
    • About GHSP
    • Editorial Team
    • Editorial Board
    • FAQs
    • Instructions for Reviewers
  • Sign up for Alerts
  • Webinars
    • Local Voices Webinar
    • Connecting Creators and Users of Knowledge
    • Publishing About Programs in GHSP
  • News
    • GHSP Call for Papers
  • Visit GHSP on Facebook
  • Follow GHSP on Twitter
  • RSS
  • Find GHSP on LinkedIn
ORIGINAL ARTICLE
Open Access

Cell Phone Counseling Improves Retention of Mothers With HIV Infection in Care and Infant HIV Testing in Kisumu, Kenya: A Randomized Controlled Study

Avina Sarna, Lopamudra Ray Saraswati, Jerry Okal, James Matheka, Danmark Owuor, Roopal J. Singh, Nancy Reynolds and Sam Kalibala
Global Health: Science and Practice May 2019, GHSP-D-18-00241; https://doi.org/10.9745/GHSP-D-18-00241
Avina Sarna
aPopulation Council, New Delhi, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: asarna@popcouncil.org
Lopamudra Ray Saraswati
bPopulation Council, New Delhi, India. Now with Research Triangle Institute, New Delhi, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jerry Okal
cPopulation Council, Nairobi, Kenya.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James Matheka
cPopulation Council, Nairobi, Kenya.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danmark Owuor
dPopulation Council, Kisumu, Kenya.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Roopal J. Singh
ePopulation Council, Delhi, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nancy Reynolds
fJohns Hopkins School of Nursing, Baltimore, MD, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sam Kalibala
gPopulation Council, Washington, DC, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Next
  • Article
  • Info & Metrics
  • Comments
  • PDF
Loading

Tailored, one-on-one counseling delivered via cell phone was very effective in retaining mothers with HIV in care and in promoting infant HIV testing and antenatal and postnatal care attendance. The highest risk of loss to follow-up among women with HIV accessing PMTCT services was prior to delivery and then after infant HIV testing at 6 weeks. Challenges include continued limited access to cell phones, difficulty with reaching participants on the phone, and poor adherence to antiretroviral therapy for a substantial percentage of the population.

ABSTRACT

Background: We evaluated the effectiveness of a cell phone counseling intervention to promote retention in care and HIV testing of infants among women with HIV accessing prevention of mother-to-child services in Kisumu, Kenya.

Methods: Between May 2013 and September 2015, we recruited 404 pregnant women with HIV who were between 14 and 36 weeks of gestation and randomly assigned them to the intervention (n=207) or control arm (n=197). Retention was assessed at delivery and at 6 and 14 weeks postpartum. We also measured uptake of infant HIV testing. The intervention comprised a fixed protocol of counselor-delivered phone calls to provide one-to-one need-based support. The number of calls made varied depending on when participants presented for antenatal care services; the maximum number was 42. The control group received routine care. We evaluated retention at 3 time points using the complementary log-log regression model taking into account factors associated with retention and loss to follow-up time. We calculated the incidence rate for HIV transmission among infants and used binary logistic regression to identify predictors of HIV infection among infants.

Results: Participants attended on average 63% of the required number of counseling calls during the study period. Retention was higher in the intervention arm than the control arm at delivery (95.2% vs. 77.7%, respectively); 6 weeks postpartum (93.9% vs. 72.9%, respectively); and 14 weeks postpartum (83.3% vs. 66.5%, respectively) (P<.001). The counseling intervention (hazard ratio [HR]=0.29; 95% confidence interval [CI]=0.12, 0.69) and positive health perceptions (HR=0.99; 95% CI=0.98, 1.00) were associated with lower hazards of being lost to follow-up. HIV testing of infants was higher in the intervention than control arm (93% vs. 68%, respectively; P<.001). In total, 9 of 308 (2.9%) infants tested positive for HIV infection (incidence rate=0.39 infections/100 infant-weeks). Medication Possession Ratio (MPR) >90%, used to assess adherence to ART, was associated with lower odds of a positive HIV test among infants (adjusted odds ratio=0.20; 95% CI=0.04, 0.99). Attendance at antenatal and postnatal care visits was higher among participants in the intervention arm than the control arm.

Conclusions: The one-on-one tailored counseling delivered via cell phone was effective in retaining mothers with HIV infection in care and promoting uptake of infant HIV testing and antenatal and postnatal care services. Phone counseling offers a practical approach to reach and retain pregnant women with HIV infection and postpartum mothers in care, but greater emphasis on collection of medications and adherence is required.

  • Received: 2018 Jul 2.
  • Accepted: 2019 Mar 12.
  • © Sarna et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-18-00241

Next
Back to top

In this issue

Global Health: Science and Practice: 10 (2)
Global Health: Science and Practice
Vol. 10, No. 2
April 28, 2022
  • Table of Contents
  • About the Cover
  • Index by Author
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Global Health: Science and Practice.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Cell Phone Counseling Improves Retention of Mothers With HIV Infection in Care and Infant HIV Testing in Kisumu, Kenya: A Randomized Controlled Study
(Your Name) has forwarded a page to you from Global Health: Science and Practice
(Your Name) thought you would like to see this page from the Global Health: Science and Practice web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Cell Phone Counseling Improves Retention of Mothers With HIV Infection in Care and Infant HIV Testing in Kisumu, Kenya: A Randomized Controlled Study
Avina Sarna, Lopamudra Ray Saraswati, Jerry Okal, James Matheka, Danmark Owuor, Roopal J. Singh, Nancy Reynolds, Sam Kalibala
Global Health: Science and Practice May 2019, GHSP-D-18-00241; DOI: 10.9745/GHSP-D-18-00241

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Cell Phone Counseling Improves Retention of Mothers With HIV Infection in Care and Infant HIV Testing in Kisumu, Kenya: A Randomized Controlled Study
Avina Sarna, Lopamudra Ray Saraswati, Jerry Okal, James Matheka, Danmark Owuor, Roopal J. Singh, Nancy Reynolds, Sam Kalibala
Global Health: Science and Practice May 2019, GHSP-D-18-00241; DOI: 10.9745/GHSP-D-18-00241
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Statistics from Altmetric.com

Jump to section

  • Article
  • Info & Metrics
  • Comments
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • A Qualitative Comparative Analysis of the Drivers of HIV Status Knowledge in Orphans and Vulnerable Children in Mozambique
  • Google Scholar

More in this TOC Section

  • The Know-Do Gap: Understanding and Improving Service Quality Among Pharmacies Providing Injectable Contraceptives Through a Mystery Client Study in Nepal
  • Implementation of HIV Retesting During Pregnancy and Postpartum in Kenya: A Cross-Sectional Study
  • Lessons Learned From the Use of the Most Significant Change Technique for Adaptive Management of Complex Health Interventions
Show more ORIGINAL ARTICLE

Similar Articles

Subjects

  • Health Topics
    • HIV/AIDS
  • Cross-Cutting Topics
    • Digital Health
US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

Follow Us On

  • Twitter
  • Facebook
  • LinkedIn
  • RSS

Articles

  • Current Issue
  • Advance Access Articles
  • Past Issues
  • Topic Collections
  • Most Read Articles
  • Supplements

More Information

  • Submit a Paper
  • Instructions for Authors
  • Instructions for Reviewers
  • GH Journals Database

About

  • About GHSP
  • Editorial Board
  • FAQs
  • Contact Us
  • Privacy Policy

© 2022 Creative Commons Attribution 4.0 International License. ISSN: 2169-575X

Powered by HighWire