Conference abstract

Determinants of adherence to antiretroviral therapy among women accessing prevention of mother to child transmission services in Ebonyi State, Nigeria

Pan African Medical Journal - Conference Proceedings. 2018:8(16).21 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.16.686

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Keywords: Adherence, antiretroviral therapy, pregnancy, prevention of mother-to-child transmission
Opening ceremony

Determinants of adherence to antiretroviral therapy among women accessing prevention of mother to child transmission services in Ebonyi State, Nigeria

Joseph Agboeze1,&, Babatunde Adedokun2, Ikeola Adeoye2, Matthew Nwali1

1Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Nigeria, 2Department of Epidemiology and Medical statistics, College of Medicine, University of Ibadan, Nigeria

&Corresponding author
Joseph Agboeze, Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Nigeria

Abstract

Introduction: globally, mother-to-child transmission (MTCT) of HIV accounts for over 90% of all pediatrics infection. High level of adherence to antiretroviral drugs is needed to achieve maximal reduction of transmission in pregnancy. The effect of poor adherence among patients is evidenced by rising numbers of HIV positive babies of mother on PMTCT Programme. The purpose of this research is to determine the level of adherence among HIV-infected pregnant women on antiretroviral therapy for prevention of mother-to-child transmission (PMTCT), and to establish the factors that contribute to adherence.

Methods: a cross-sectional study was conducted among HIV positive pregnant women from PMTCT clinic of Federal Teaching Hospital Abakaliki. Two hundred and sixty-eight 268 were recruited by systematic random sampling using pre-tested interviewer-administered questionnaire. Information on socio-demographic characteristics, knowledge of PMTCT, barriers to PMTCT and obstetric characteristics were obtained. Knowledge on PMTCT was accessed and a score of < 80% indicated poor knowledge. Adherence was self- reported and calculated based on a 3-day recall. A value <95% indicated poor adherence. Data were analyzed using descriptive statistics, Chi square and logistic regression with confidence interval set at 95%.

Results: the mean age was 30.7 ± 4.2 years. Two hundred and nineteen (81.7%) of the respondents were married, 124 (46.3%) were traders and 141 (52.6%) had secondary education. The level of good adherence was 89.2% and 227 (89.0%) had good knowledge of PMTCT. Fear of being identified as HIV positive (21%) pregnancy related illness (13.7%) and forgetfulness (12.5%) were the most common reasons for non-adherence. Partners support [OR = 0.03 (95% CI = 0.01-0.09)], and Duration of ART use [OR = 4.39 (95% CI = 1.3 - 14.5)] were found to be significantly associated with good adherence. Only partner’s support was predictor of good adherence [aOR = 0.03 (95% CI = 0.01 - 0.09)].

Conclusion: the level of adherence was high among study participants. Stigmatization and pregnancy-related illness were associated with poor adherence while having partners’ support improve adherence to HAART. Interventions aimed at improving ART adherence in pregnancy should focus on these factors to guide counseling and to design programs.