# A Randomized Controlled Trial of Women Involved in Supporting Health (WISH), a Peer-Led Intervention to Improve Postpartum Retention in HIV Care

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2021 · $518,259

## Abstract

In the United States, rates of postpartum retention in care and viral suppression are extremely poor among
women living with HIV (WLH). In Philadelphia, PA, from 2005 to 2011, only 39% of WLH were retained in HIV
care during the first year following delivery and that number had dropped to 25% at year two. Retention rates in
the South are similar, ranging from 37% in Mississippi (1999-2006) to 47% in Atlanta, GA (2011-2015). Retention
in HIV care particularly affects black and Hispanic women as they are disproportionately affected by the HIV
epidemic. Retaining WLH in care positively impacts their well-being and health postpartum and for years to
come, which promotes not only their health but that of their newborns.
Through a critical review of research literature, we found that interventions to improve maternal retention have
been implemented in low- or moderate-resource countries, but studies in high-resource countries are lacking. In
sub Saharan Africa, the use of peers has resulted in significantly higher maternal retention and viral suppression
compared to standard of care. Peers are WLH who remained engaged in HIV care postpartum, and provide
education and support to WLH in the prenatal and postpartum periods. We propose to test the efficacy of a
theory-driven peer intervention, based on the integrated model of health behavior, through a multi-site
randomized control trial (RCT). The peer intervention—Women Involved in Supporting Health (WISH)—is
designed to increase self-efficacy, social support, self-regulatory behaviors, and outcome expectancy in order to
improve retention in care and viral suppression postpartum. The intervention is an adaptation of the International
Center for AIDS Care and Treatment peer curriculum, developed for sub Saharan African pregnant WLH. It will
consist of 3 face-to-face prenatal sessions to address barriers to outcome expectancies and self-efficacy in the
third trimester and 6 face-to-face postpartum sessions scheduled up to 3 months postpartum. The postpartum
sessions build on outcome expectancy and knowledge acquired in the prenatal sessions to develop skills tailored
toward increasing ART adherence and engagement in HIV care after delivery.
The multisite RCT will take place across Center for AIDS Research sites in Philadelphia, Washington DC, Atlanta
and Birmingham, all cities where HIV infection rates remain disproportionally high among black and Hispanic
women. A total of 260 pregnant WLH will be randomized to either the WISH intervention or to an attention-
matched health-awareness control group. Primary and secondary outcomes include retention in HIV care and
viral suppression at 1 year postpartum. The study will also evaluate how theoretical variables (self-efficacy, social
support, self-regulation, outcome expectancy, and depressive symptoms) mediate study outcomes. The impact
of this research will be the development of the first evidence-based peer intervention to address the pressing
need to improv...

## Key facts

- **NIH application ID:** 10128219
- **Project number:** 5R01MD013558-05
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** FLORENCE M MOMPLAISIR
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $518,259
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10128219

## Citation

> US National Institutes of Health, RePORTER application 10128219, A Randomized Controlled Trial of Women Involved in Supporting Health (WISH), a Peer-Led Intervention to Improve Postpartum Retention in HIV Care (5R01MD013558-05). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10128219. Licensed CC0.

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