title: The impact of mentor mother programs on PMTCT service uptake and retention-in-care at primary health care facilities in Nigeria: a prospective cohort study (MoMent Nigeria).
abstract: BACKGROUND
  Nigeria is a key target country in the global effort toward elimination of mother-to-child transmission of HIV. Low coverage of prevention of mother-to-child transmission (PMTCT) interventions, adherence, and retention-in-care rates in HIV-positive pregnant women are contributing factors to high mother-to-child transmission of HIV (MTCT) rates. In Nigeria, rural areas, served largely by primary health care facilities, have particularly poor indicators of PMTCT coverage. Mentor Mothers are HIV-positive women who serve as peer counselors for PMTCT clients, provide guidance, and support in keeping appointments and promoting antiretroviral adherence and retention-in-care. The Mother Mentor (MoMent) study aims to investigate the impact of structured Mentor Mother programs on PMTCT outcomes in rural Nigeria.
  
  
  METHODS
  A prospective cohort study will compare rates of retention-in-care among PMTCT clients who are supported by formally-trained supervised Mentor Mothers versus clients who receive standard-of-care, informal peer support. Study sites are 20 primary health care centers (10 intervention, 10 control) in rural North-Central Nigeria. The study population is HIV-positive mothers and exposed infant pairs (MIPs) (N = 480; 240 MIPs per study arm). Primary outcome measures are the proportion of exposed infants receiving early HIV testing by age 2 months, and the proportion of MIPs retained in care at 6 months postpartum. Secondary outcome measures examine antiretroviral adherence, 12-month postpartum MIP retention, and MTCT rates. This article presents details of the study design, the structured Mentor Mother programs, and how their impact on PMTCT outcomes will be assessed.
authors.affiliation: *Clinical/Community Departments, Institute of Human Virology Nigeria, Abuja, Nigeria; †Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD; ‡School of Social Work, University of Maryland, Baltimore, MD; §Clinton Health Access Initiative, Abuja, Nigeria; ‖Department of Pediatrics, Obafemi Awolowo University, Ile Ife, Nigeria; ¶Department of Obstetrics and Gynecology, Bayero University, Kano, Nigeria; #Department of Community Medicine, Equitable Health Access Initiative, Lagos, Nigeria; **HIV/AIDS Division, Federal Ministry of Health, Abuja, Nigeria; and ††Department of Obstetrics and Gynecology, University of Uyo, Uyo, Nigeria.
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Sam-Agudu
authors.forename: Llewellyn J
authors.initials: LJ
authors.lastname: Cornelius
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Okundaye
authors.forename: Olusegun A
authors.initials: OA
authors.lastname: Adeyemi
authors.forename: Haroun O
authors.initials: HO
authors.lastname: Isah
authors.forename: Owens M
authors.initials: OM
authors.lastname: Wiwa
authors.forename: Ebun
authors.initials: E
authors.lastname: Adejuyigbe
authors.forename: Hadiza
authors.initials: H
authors.lastname: Galadanci
authors.forename: Abayomi J
authors.initials: AJ
authors.lastname: Afe
authors.forename: Ibidun
authors.initials: I
authors.lastname: Jolaoso
authors.forename: Emem
authors.initials: E
authors.lastname: Bassey
authors.forename: Manhattan E
authors.initials: ME
authors.lastname: Charurat
mesh_terms: D005260:Female; D015658:HIV Infections / Q000150:complications / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D008611:Mentors; D009549:Nigeria; D010349:Patient Compliance; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011446:Prospective Studies; D018401:Sample Size; D019562:Viral Load