Level of Adherence and Associated Factors to Option B+ PMTCT among HIV Positive Pregnant Women in Hadiya Zone, Southern Ethiopia
Keywords:
Adherence, Option B PMTCT, Hadiya zoneAbstract
Background: Option B+ is a test and treat strategy in which HIV+ pregnant women are initiated on antiretroviral therapy regardless of their immunologic status & clinical status and are maintained on treatment for life in an attempt to avert mother to child transmission of HIV and improve the survival of mothers, newborns and children. Adherence is the single most important modifiable factor to achieve the above outcome. Non-adherence to PMTCT drugs increases the risk of treatment failure, maternal HIV disease progression, and the potential development of drug-resistant virus. The study aimed to identify the level of adherence to the Option B+ PMTCT programme and factors associated with adherence among HIV positive pregnant women in the Hadiya zone, southern Ethiopia, 2016.
Methods: A facility based cross-sectional study was conducted among 215 HIV-positive pregnant women in 2016. Data were collected using a structured interviewer-administered questionnaire. Data were entered into Epi-Data Statistical software version 3.1, and exported to SPSS version 21 for analysis. Descriptive statistics such as frequencies, proportions, and means were carried out. Multiple logistic regressions were used to estimate the effect sizes of factors associated with adherence to Option B+ PMTCT drugs.
Results: The adherence level of respondents to option B+ PMTCT drugs was 83.7% (95 % CI: 78.3, 88.6). Mothers who were counseled on the side effects of ARV medications had 7.2 times higher odds (aOR 7.2, 95% CI 2.2, 22.8) of adhering to Option B+ PMTCT care and support as compared to those who were not counseled properly. Disclosing their HIV status to their partner was also positively associated with good adherence (aOR 3.09, 95% CI 1.04, 9.1). HIV positive pregnant women with good partner involvement in PMTCT care and support had 72% more likely to be adherent to option B+ PMTCT as compared to low (aOR 0.28; 95% CI: 0.06, 0.12).
Conclusion: The adherence level of mothers towards PMTCT care and support was 83.7%. Proper counseling on the side effects of PMTCT drugs, care and support, HIV status disclosure to partners and Male partner involvement were significant predictors of adherence to PMTCT.Downloads
References
WHO (2014), United Nations Program on HIV/AIDS, AIDS epidemic update. Geneva: WHO; 2014.
WHO (2015), Consolidated strategic information guidelines for HIV in the health sector, May, 2015.
WHO, UNICEF, UNAIDS. Global HIV/AIDS response. Epidemic update and health sector progress towards universal access. Geneva: WHO; 2011.
James McIntyre, ANOVAs Health Institute & School of Public Health &Family Medicine, University of Cape Town, Update On Option B+ Success & Challenge, 2014.
Federal Ministry of Health (2013); National comprehensive PMTCT/MNCH/RH training package guideline reference manual FMOH, Addis Ababa
Eliud Wekesa, ART adherence in resource poor settings in sub-Saharan Africa: a multidisciplinary review, 2013.
WHO(2003) Adherence to Long-term Therapies: Evidence for Action. Washington, D.C., World Health Organization.
Landovitz RJ. What's the best way to measure ART adherence? Journal Watch. 2011:23 (3).
Paterson, DL, Swindells, S, Mohr J, Brester, M, Vergis, EN, Squier, C, Wagener, MM &Singh, N. 2000. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine 133(1):21-30.
WHO(2013). Global update on HIV treatment 2013: results, impact and opportunities. Geneva: WHO
Ramadhani, HO, Thielman, NM, Landman, KZ, Ndosi, EM, Gao, F, Kirchherr, JL, Shah, R, Shao, HJ, Morpeth, SC, McNeill, JD, Shao, JF, Bartlett, JA & Crump, JA. 2007. Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. The Infectious Diseases Society of America. Clinical Infectious Diseases 45(11):1492-1498.
R. Gross, W. Bilker, H. Friedman, B. Strom Effect of adherence to newly initiated antiretroviral therapy on plasma viral load AIDS, 2001(15):2109-2117
R. Smith Adherence to antiretroviral HIV drugs: how many doses can you miss before resistance emerges? Proc Biol Sci, 2006(273):617-624
H, Yebyo H, Alemayehu M, Adherence level to and predictors of Option B+ PMTCT program in Tigray, Northern Ethiopia, International
Journal of Infectious Diseases (2014), http://dx.doi.org/10.1016/j.ijid.2014.12.026
E. Gardner, W. Burman, M. Maravi, A. Davidso Settings towards universal access: recommendations for a selective drug taking during combination antiretroviral therapy in an unselected clinic population J Acquired Immune Defic Syndr, 2005;(40):294-300
Hadiya Zone health department biannual report, 2014
Gavin S, Jude N, Mohan J. Development of a multi-method tool to measure ART adherence in resource-constrained settings of the South Africa experience. Rational Pharmaceutical Management Plus Program Center for Pharmaceutical Management. Management Sciences for Health, 4301 North Fairfax Drive, Suite 400; Arlington, VA 22203 USA; 2007.
Simoni JM, Montgomery A, Martin E, New M, Demas PA, Rana S. Adherence to antiretroviral therapy for pediatric HIV infection: a qualitative systematic review with recommendations for research and clinical management. Pediatrics. 2007:119(6):13711383.
Ng'ambi WF, Tweya H, Speight C, Man-Bourdon C, Hosseinpour M, Phiri S. Determinants of antiretroviral treatment adherence among women accessing PMTCT "˜"˜Option B+'': a retrospective study at Bwaila Hospital, Malawi. IAS Conference on HIV Pathogenesis, treatment and prevention, 30 June-03 July 2013-Kuala Lumpur, Malaysia, MOPE129-Poster Exhibition.
Igwegbe AO, Ugboaja JO, Nwajiaku LA. Prevalence and determinants of non-adherence to antiretroviral therapy among HIV-positive pregnant women in Nnewi, Nigeria. International Journal of Medicine and Medical Sciences 2010;2 (8):238-45.
Ekama SO, Herbert son EC, Addeh EJ, Gab-Okafor CV, Onwujekwe DI, Tayo F, et al. Pattern and determinants of antiretroviral drug adherence among Nigerian pregnant women. J Pregnancy 2011; 2012:1-7.
Mirkuzie A, Hinderaker S, Sisay M, Moland K, Morkve O. Current status of medication adherence and infant follow up in the prevention of mother to child HIV transmission programme in Addis Ababa: a cohort study. Journal of International AIDS Society 2011; 14(50).
Kirsten I, Sewangi J, Kunz A, Dugange F, Ziske J. Adherence to Combination Prophylaxis for Prevention of Mother-to-Child-Transmission of HIV in Tanzania. 2011; 6(6):e21020. http://dx.doi.org/10.1371/journal.pone. 0021020
Daniel B, Golda DK, Peter AB. Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV-positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Womens Health 2013;13:2
Bangsbergab D, Hechtb F, Charleboisa E, Zolopaf A, Holodniyfg M, Sheinerc L, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000; 14:357-66.
Cauldbeck M, O'Connor C, O'Connor M, Saunders J, Rao B, Mallesh V, et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. BMC 2009;6(7).
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