{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:26:59Z","timestamp":1788226019482,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["D43TW009574"],"award-info":[{"award-number":["D43TW009574"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>India\u2019s national AIDS Control Organization implemented World Health Organization\u2019s option B+ HIV prevention of mother\u2010to\u2010child transmission (PMTCT) guidelines in 2013. However, scalable strategies to improve uptake of new PMTCT guidelines to reduce new infection rates are needed. This study assessed impact of Mobile Health\u2010Facilitated Behavioral Intervention on the uptake of PMTCT services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cluster\u2010randomized trial of a mobile health (mHealth)\u2010supported behavioural training intervention targeting outreach workers (ORWs) was conducted in four districts of Maharashtra, India. Clusters (one Integrated Counselling and Testing Center (ICTC, n\u00a0=\u00a0119), all affiliated ORWs (n\u00a0=\u00a0116) and their assigned HIV\u2010positive pregnant\/postpartum clients (n\u00a0=\u00a01191)) were randomized to standard\u2010of\u2010care (SOC) ORW training vs. the COMmunity home Based INDia (COMBIND) intervention \u2013 specialized behavioural training plus a tablet\u2010based mHealth application to support ORW\u2010patient communication and patient engagement in HIV care. Impact on uptake of maternal antiretroviral therapy at delivery, exclusive breastfeeding at six months, infant nevirapine prophylaxis, and early infant diagnosis at six months was assessed using multi\u2010level random\u2010effects logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1191 HIV\u2010positive pregnant\/postpartum women, 884 were eligible for primary outcome assessment; 487 were randomized to COMBIND. Multivariable analyses identified no statistically significant differences in any primary outcome by study arm. COMBIND was associated with higher uptake of exclusive breastfeeding at two months (adjusted Odds Ratio (aOR), 2.10; 95% CI 1.06 to 4.15) and early infant diagnosis at six weeks (aOR, 2.19; 95% CI 1.05 to 3.98) than SOC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The COMBIND intervention was easily integrated into India\u2019s existing PMTCT programme and improved early uptake of two PMTCT components that require self\u2010motivated health\u2010seeking behaviour, thus providing preliminary evidence to support COMBIND as a potentially scalable PMTCT strategy. Further study would identify modifications needed to optimize other PMTCT outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25555","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T07:40:32Z","timestamp":1593762032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A mobile health\u2010facilitated behavioural intervention for community health workers improves exclusive breastfeeding and early infant HIV diagnosis in India: a cluster randomized trial"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8917-0302","authenticated-orcid":false,"given":"Nishi","family":"Suryavanshi","sequence":"first","affiliation":[{"name":"Lakshya, Society for Public Health Education and Research Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Kadam","sequence":"additional","affiliation":[{"name":"Lakshya, Society for Public Health Education and Research Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Gupte","sequence":"additional","affiliation":[{"name":"School of Medicine Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha","family":"Hegde","sequence":"additional","affiliation":[{"name":"National AIDS Control Organization New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savita","family":"Kanade","sequence":"additional","affiliation":[{"name":"Lakshya, Society for Public Health Education and Research Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srilatha","family":"Sivalenka","sequence":"additional","affiliation":[{"name":"Division of Global HIV &amp; TB \u2013 India Country Office US Centers for Disease Control and Prevention New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V Sampath","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Global HIV &amp; TB \u2013 India Country Office US Centers for Disease Control and Prevention New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-2718","authenticated-orcid":false,"given":"Amita","family":"Gupta","sequence":"additional","affiliation":[{"name":"School of Medicine Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C","family":"Bollinger","sequence":"additional","affiliation":[{"name":"School of Medicine Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Shankar","sequence":"additional","affiliation":[{"name":"Bloomberg School of Public Health Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"McKenzie\u2010White","sequence":"additional","affiliation":[{"name":"School of Medicine Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Mave","sequence":"additional","affiliation":[{"name":"School of Medicine Johns Hopkins University Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,3]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization.Antiretroviral drugs for treating pregnant women and preventing HIV transmission in infants. 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