Assessing the impact, barriers and facilitators of peer-driven interventions on the prevention of mother-to-child transmission of HIV in low- and middle-income countries: A systematic review and meta-analysis.
Victor Oluwafemi Femi-Lawal, Rhoda Fadairo, Joshua Alabi et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis assessed peer-driven interventions for prevention of mother-to-child HIV transmission in low- and middle-income countries. It included 27 studies involving 26 431 participants across 10 countries. Peer interventions were associated with improved ART adherence at one year (OR: 1.19, 95% CI: 1.05-1.35) and two years (OR: 2.04, 95% CI: 1.58-2.64), alongside gains in several infant and postpartum outcomes. Effects were not significant for ART initiation, 12-month retention or HIV status disclosure. Stigma, limited mentor training and logistical and economic constraints were reported as barriers.
Key findings
- ART adherence was higher with peer interventions at one year (OR: 1.19, 95% CI: 1.05-1.35) and two years (OR: 2.04, 95% CI: 1.58-2.64).
- Interventions improved six-week postpartum PMTCT retention (OR: 2.63, 95% CI: 1.56-4.43) and infant uptake of HIV prophylaxis (OR: 2.95, 95% CI: 1.90-4.59).
- Early infant diagnosis (OR: 1.64, 95% CI: 1.01-2.67) and viral load testing (OR: 1.21, 95% CI: 1.07-1.38) also improved.
- No significant effects were found for ART initiation, 12-month PMTCT retention or HIV status disclosure.
Why it matters
The findings suggest peer support may strengthen engagement at several points in the PMTCT cascade, including maternal adherence and infant prophylaxis and testing. However, benefits were not consistent across outcomes, and the review identifies implementation barriers such as stigma and inadequate mentor training. These results highlight the importance of considering both intervention delivery and local health-system context when evaluating peer-support approaches.
What to keep in mind
The review combines studies across 10 countries and reports mixed effects across outcomes; the abstract does not provide further detail on study-level design or risk of bias.