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)