# A community-based adaptation of a peer-led intervention to address alcohol use and HIV risk in pregnant women in South Africa (Mentor Moms+)

> **NIH NIH R34** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2024 · $182,199

## Abstract

PROJECT SUMMARY
The syndemic of alcohol use and HIV risk in pregnant and lactating people (PLP) threatens the health of
mother, fetus, children and families in South Africa. PLP living with HIV who use alcohol may access
antiretroviral therapy (ART) late or disengage with ART care, increasing the risk of vertical HIV transmission.
PLP not living with HIV who use alcohol are at increased risk of HIV and may require targeted interventions to
receive pre-exposure prophylaxis (PrEP) delivery and adherence counselling. Alcohol use also increases risk
of HIV acquisition and poor ART adherence. The “mentor mother” (MM) intervention model is an evidence-
based intervention (EBI) with demonstrated success in improving HIV and antenatal care outcomes. The
model utilizes a task-shifting approach; positive deviant peers (mothers) deliver interventions to PBFW within
and outside of the antenatal clinic. In the present study, we will collaborate with community partners to identify
facilitators of alcohol use among PLP in SA. We will then adapt the MM model to create MM+ for PLP who
use alcohol to evaluate the feasibility of an alcohol reduction intervention that includes HIV prevention and
treatment (serostatus neutral) in a high alcohol using and HIV burdened community. Specific aims include:
· Aim 1: Mixed methods assessment of perceptions of alcohol use in pregnancy and facilitators of
 alcohol reduction in pregnancy among multilevel stakeholders of PLP who use alcohol to identify
 clinic and community level facilitators that could be used to reduce the use of alcohol during
 pregnancy through in-depth interviews (IDIs) and brief surveys with drinking peers, intimate partners and
 focus group discussions with healthcare providers and community leaders.
· Aim 2: Adapt and refine enhanced MM intervention (MM+) with potential intervention beneficiaries,
 providers and community leaders. Use community based participatory approach research principles to
 iteratively adapt, test and refine the MM+ intervention to integrate alcohol reduction content in one
 collaborative workshop session.
· Aim 3: Evaluate the feasibility and acceptability of MM+ on reduction of alcohol use (primary
 outcome) and PrEP use (in PLP without HIV) and ART adherence (in PLP living with HIV)
 (secondary outcomes) in a pilot randomized control trial (RCT) in n=100 pregnant women who currently
 use alcohol. Primary outcome: Reduced alcohol use following the intervention (at 6m via
phosphatidylethanol [PEth] levels). Secondary outcomes: PrEP and ART continued use at 6m via urine
tenofovir levels at 6m. Secondary implementation outcomes: feasibility (provider, organizational and
 participant feedback), acceptability and fidelity to the intervention SOPs.
Our study seeks to effectively reduce alcohol use and improve HIV care outcomes through community
engagement and a novel participant informed intervention adaptation and delivery process.

## Key facts

- **NIH application ID:** 10921001
- **Project number:** 1R34AA030942-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Zaynab Essack
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $182,199
- **Award type:** 1
- **Project period:** 2024-09-15 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10921001

## Citation

> US National Institutes of Health, RePORTER application 10921001, A community-based adaptation of a peer-led intervention to address alcohol use and HIV risk in pregnant women in South Africa (Mentor Moms+) (1R34AA030942-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10921001. Licensed CC0.

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