# HIV viral suppression and prevention of postpartum weight retention in South Africa: A pilot trial

> **NIH NIH R34** · BROWN UNIVERSITY · 2024 · $1

## Abstract

PROJECT SUMMARY/ABSTRACT
Availability of antiretroviral therapy (ART) coverage to pregnant women for life through Option B+ has been a
major advance in sub-Saharan Africa for maternal health; however, postpartum mothers living with HIV are at
risk for disengagement from HIV care and treatment non-adherence. Postpartum women are an important
population for efforts to improve HIV treatment adherence and addressing the role of HIV stigma is imperative
in the South African context. HIV stigma is also a key driver of weight and body size in this population. Larger
bodies have generally been preferred among women living with HIV to combat the perception of rapid weight
loss being an outward sign of rapidly declining health and AIDS-diagnosis. However, there are concerns about
excessive weight gain and adverse outcomes related to obesity in HIV positive populations, given ART
associated weight-gain concerns on top of population level increases in obesity. Excessive gestational weight
gain and postpartum weight retention are associated with poor maternal health outcomes including pregnancy-
related hypertensive disorders, large for gestational age babies, increased cesarean birth rates, childhood
obesity as well as maternal type 2 diabetes and cardiovascular disease. HIV stigma and cultural preferences
must be addressed in interventions designed to improve HIV treatment adherence and postpartum weight
retention in this population, necessitating a contextually tailored intervention. This proposal will develop and
refine a lay health worker delivered multicomponent behavioral intervention to address the behavioral
determinants of both HIV viral suppression and postpartum weight retention. Aim 1 will refine the planned
intervention through participatory qualitative data collection with the patient population and key stakeholders.
Aim 2 will evaluate the feasibility and preliminary efficacy of the postpartum weight reduction and HIV viral
suppression intervention for postpartum women living with HIV. Aim 3 will assess the acceptability and perceived
usefulness of the intervention and identify potential mechanisms of change to be tested in a future large-scale
RCT. The proposed study will make a significant contribution to our understanding of intervention techniques to
address both HIV viral suppression and postpartum weight retention among mothers living with HIV, a critically
important population for improved prevention and care. Findings from this work will be used to develop an R01
application to test the efficacy of our culturally and contextually appropriate HIV treatment and postpartum weight
retention intervention in a large-scale RCT.

## Key facts

- **NIH application ID:** 10924784
- **Project number:** 1R34MH135761-01A1
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Lucia Knight
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1
- **Award type:** 1
- **Project period:** 2024-09-15 → 2024-09-16

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10924784

## Citation

> US National Institutes of Health, RePORTER application 10924784, HIV viral suppression and prevention of postpartum weight retention in South Africa: A pilot trial (1R34MH135761-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10924784. Licensed CC0.

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