Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jun 10, 2025
Date Accepted: Sep 30, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Community-Based Adaptation and Evaluation of a Peer-Led Intervention to Address Alcohol Use and HIV in Pregnant Women in South Africa: Protocol for Mentor Mothers+ Study
ABSTRACT
Background:
Pregnant and lactating women (PLW) in South Africa face high rates of alcohol use and HIV, both of which have significant impacts on maternal and infant health. Despite the availability of evidence-based interventions for HIV prevention, few programs address alcohol use and HIV risk concurrently in this population. The Mentor Mothers+ (MM+) study seeks to adapt and evaluate a peer-led intervention to integrate alcohol reduction strategies with HIV prevention support for PLW in a community-based setting.
Objective:
To adapt and pilot a peer-delivered, multi-session psychosocial support intervention—Mentor Moms+ (MM+)—to reduce alcohol use and HIV risk (in a seroneutral intervention) among pregnant women in Saldanha Bay, Western Cape.
Methods:
In collaboration with the Foundation for Alcohol Related Research (FARR), we will use the ADAPT-ITT framework and a Theory of Change methodology to modify the evidence-based "mentor mother" (MM) model, originally focused on vertical HIV transmission. Our mixed-methods design includes: (1) Qualitative research: Up to 30 in-depth interviews (IDIs) with partners and friends or family members of pregnant women who drink alcohol, and focus group discussions (FGDs) with up to 20 healthcare and community stakeholders, to assess drivers of perinatal alcohol use from the perspectives of individuals who influence behaviors; (2) Intervention adaptation: Two community-based participatory workshops with stakeholders — including pregnant women who use alcohol, their partners, family members, and healthcare providers — to refine the MM+ intervention, ensuring the integration of culturally and contextually appropriate alcohol reduction strategies; and (3) Pilot RCT: Testing feasibility and acceptability among 100 pregnant women who use alcohol in a pilot randomized controlled trial. Primary outcomes of the trial include reduced alcohol use, measured objectively via phosphatidylethanol (PEth) blood levels at six-month follow-up. Secondary outcomes include uptake of HIV pre-exposure prophylaxis (PrEP) among participants without HIV, adherence to antiretroviral therapy (ART) among women living with HIV, and intervention fidelity, feasibility, and acceptability.
Results:
At the time of protocol submission, focus groups have been completed, and in-depth interview data collection and analysis is ongoing. Findings from formative research will inform intervention adaptation through planned community workshops.
Conclusions:
Our community-based, participatory study, Mentor Mothers+, offers a promising approach to address co-occurring alcohol use and HIV among PLW. Stakeholder engagement will enhance contextual relevance and support future scalability. Clinical Trial: NCT06962592
Citation
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Copyright
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