Evidence map›Paper›PMID 37608373›Full record

Trial reportBMC women's health2023

Changes in relationships, HIV risk, and feelings towards PrEP: findings from a qualitative explanatory study among participants in the CHARISMA intervention trial.

Miriam Hartmann, Noah Triplett, Sarah T Roberts, Michele Lanham, Krishnaveni Reddy, Siyanda Tenza, Nonkululeko Mayisela, Dorica Mbewe, Ontathile Maboa, Lydia Mampuru and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC women's health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Miriam HartmannWomen's Global Health Imperative, RTI International, Berkeley, California, USA. mhartmann@rti.org.
Noah TriplettWomen's Global Health Imperative, RTI International, Berkeley, California, USA.
Sarah T RobertsWomen's Global Health Imperative, RTI International, Berkeley, California, USA.
Michele LanhamFHI360, Durham, USA.
Krishnaveni ReddyWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Siyanda TenzaWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Nonkululeko MayiselaWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Dorica MbeweWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Ontathile MaboaWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Lydia MampuruWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Elizabeth E TolleyFHI360, Durham, USA.
Thesla Palanee-PhillipsWits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Elizabeth T MontgomeryWomen's Global Health Imperative, RTI International, Berkeley, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntimate partner violence (IPV) and other relationship-based challenges have been demonstrated to reduce women's ability to use pre-exposure prophylaxis (PrEP) effectively for HIV prevention. The Community Health Clinical Model for Agency in Relationships and Safer Microbicide Adherence (CHARISMA) intervention was designed to mitigate these challenges and increase South African women's agency to use PrEP. The CHARISMA randomized controlled trial did not identify statistically significant differences in PrEP adherence or relationship dynamics between the intervention and control arms. As such, the aim of this explanatory qualitative sub-study was to understand women's experiences with the CHARISMA trial and explore reasons for the null results.

methodsTwelve CHARISMA trial participants were purposively selected to participate in serial in-depth interviews, which took place at the trial end and 3 months later. Participants represented individuals who had received each of the three counselling modules, 1) healthy communication counselling, 2) PrEP disclosure counselling, or 3) IPV counselling, as well as those in the control arm who received IPV standard-of-care counselling.

resultsA thematic case analysis revealed numerous positive relationship outcomes among intervention participants, including identifying and ending unhealthy relationships, gaining a sense of personal empowerment, and enacting more positive behaviors and HIV risk reduction strategies in subsequent relationships. These positive shifts were occasionally described as contributing to decisions to discontinue PrEP use, which may partly explain the limited impact of the intervention on PrEP adherence.

conclusionsFuture investigations of counselling interventions addressing relationship-based barriers to PrEP use should account for changing risk dynamics and need for PrEP.

Indexed as

Anti-Infective AgentsHIV InfectionsPre-Exposure ProphylaxisCounselingEmotionsEmpowermentFemaleHealth Risk BehaviorsHumansMedication AdherenceResearch DesignAnti-Infective AgentsAdult womenEmpowerment-based counselling interventionHIV preventionIntimate-partner violencePre-exposure prophylaxisSouth Africa

Identifiers

PMID37608373
PMCPMC10464438

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.