# A Couples-Based Intervention and Postpartum Contraceptive Uptake in Zambézia Province, Mozambique

> **NIH NIH F30** · VANDERBILT UNIVERSITY · 2022 · $43,895

## Abstract

PROJECT SUMMARY/ABSTRACT
There is strong evidence that incorporating male partners into prenatal care for women living with HIV in sub-
Saharan Africa improves treatment outcomes, but there is scant understanding about how these interventions
impact postpartum contraceptive uptake. Postpartum contraceptive initiation and continued use (uptake) has a
profound impact on the health of the mother and her child. More than 50% of pregnancies among women living
with HIV in sub-Saharan Africa are unintended; therefore, enhanced postpartum contraceptive uptake would
decrease maternal and child morbidity and mortality. This project will supplement the ongoing Homens para
Saúde Mais (HoPS+) [Men for Health Plus] trial – 829 of 1080 planned HIV+ couples enrolled as of 12/19/2019
– a cluster randomized controlled trial to improve maternal HIV treatment uptake via couples-based HIV care
and enhanced male partner support in Zambézia Province, Mozambique. Couples in the HoPS+ intervention
group receive joint – as opposed to individual – HIV-management during the antenatal and postpartum period
and six counselling sessions to develop shared decision making, communication, and conflict resolution skills.
The intervention facilitates conversations about postpartum contraception uptake.
I will assess whether couple-based care increases postpartum modern contraceptive uptake – defined as
hormonal, barrier, and spermicidal methods. I will conduct a systematic review to quantify how couples-based
interventions influence modern postpartum contraceptive uptake (Aim 1). This will capture heterogeneity
across previous studies and contribute to a robust conceptual map of how male-partner involvement influences
postpartum contraceptive use within the information, motivation, behavior model. I will then utilize a thematic
analysis to qualitatively explore perceptions of, attitudes towards, and experiences with modern contraceptive
use among 20-30 couples in the study (Aim 2). I will gain an understanding about local perceptions of, attitudes
towards, and experiences with modern contraceptive use from study participants’ answers to four questions I
added to the HoPS+ trial in-depth qualitative interviews. Lastly, I will quantitatively assess the impact of HoPS+
on modern postpartum contraceptive uptake during the 12 months from live birth among women living with HIV
(Aim 3). I will assess the odds of modern contraceptive uptake with a generalized linear mixed effect model to
account for clustering by study site. I will also assess how attendance at each counselling session among
intervention group participants impacts modern postpartum contraceptive uptake during the 12 months from
live birth. This project will expand the impact of the HoPS+ trial and prepare me for a career as a public health
researcher with an active clinical practice who studies how behavioral interventions impact human health.

## Key facts

- **NIH application ID:** 10456952
- **Project number:** 5F30MH123219-03
- **Recipient organization:** VANDERBILT UNIVERSITY
- **Principal Investigator:** Daniel Eli Sack
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $43,895
- **Award type:** 5
- **Project period:** 2020-08-01 → 2023-05-12

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10456952

## Citation

> US National Institutes of Health, RePORTER application 10456952, A Couples-Based Intervention and Postpartum Contraceptive Uptake in Zambézia Province, Mozambique (5F30MH123219-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10456952. Licensed CC0.

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