title: Pregnancy as a window of opportunity for HIV prevention: effects of an HIV intervention delivered within prenatal care.
abstract: OBJECTIVE
  We sought to determine whether an HIV prevention program bundled with group prenatal care reduced sexually transmitted infection (STI) incidence, repeat pregnancy, sexual risk behavior, and psychosocial risks.
  
  
  METHODS
  We conducted a randomized controlled trial at 2 prenatal clinics. We assigned pregnant women aged 14 to 25 years (N = 1047) to individual care, attention-matched group care, and group care with an integrated HIV component. We conducted structured interviews at baseline (second trimester), third trimester, and 6 and 12 months postpartum.
  
  
  RESULTS
  Mean age of participants was 20.4 years; 80% were African American. According to intent-to-treat analyses, women assigned to the HIV-prevention group intervention were significantly less likely to have repeat pregnancy at 6 months postpartum than individual-care and attention-matched controls; they demonstrated increased condom use and decreased unprotected sexual intercourse compared with individual-care and attention-matched controls. Subanalyses showed that being in the HIV-prevention group reduced STI incidence among the subgroup of adolescents.
  
  
  CONCLUSIONS
  HIV prevention integrated with prenatal care resulted in reduced biological, behavioral, and psychosocial risks for HIV.
authors.affiliation: School of Public Health, and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT 06510, USA. trace.kershaw@yale.edu
authors.forename: Trace S
authors.initials: TS
authors.lastname: Kershaw
authors.forename: Urania
authors.initials: U
authors.lastname: Magriples
authors.forename: Claire
authors.initials: C
authors.lastname: Westdahl
authors.forename: Sharon Schindler
authors.initials: SS
authors.lastname: Rising
authors.forename: Jeannette
authors.initials: J
authors.lastname: Ickovics
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care; D012309:Risk-Taking; D021841:Safe Sex; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D055815:Young Adult