Data collection
At the first antenatal care visit, participants responded to an interviewer-administered questionnaire that collected data on sociodemographic characteristics, medical history, partner characteristics, condom use, HIV status and treatment, previous STI diagnoses and treatment, and alcohol use and smoking during pregnancy. Data were also abstracted from the participant’s hand-held obstetric record, including obstetric and birth history, rapid HIV test results, other laboratory results (e.g. syphilis), weight, and blood pressure. In Botswana, clinicians record obstetric and medical data, laboratory results, treatments, and delivery information in the patient-held record.
At the third trimester visit, participants were asked about new sex partners, STI symptoms, treatment, and diagnoses; as well as alcohol and tobacco use. The patient-held obstetric record was also reviewed to confirm new diagnoses and record blood pressure and laboratory results. At the postnatal care visit, information was collected on the number of antenatal care visits, new STI symptoms and treatment, new sex partners, new test results; and delivery information, including location, delivery type (spontaneous vaginal delivery, breech vaginal delivery, assisted vaginal delivery, elective caesarian section, emergency caesarian section), and singleton vs multiple births. Neonatal information was also collected, including gestational age at delivery, birth weight, length, head circumference, and sex. All study data were entered directly into a Health Insurance Portability and Accountability Act (HIPAA)-compliant REDCap electronic database hosted at the Botswana Harvard AIDS Institute Partnership (Research Electronic Data Capture, Vanderbilt University, USA).(13)