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Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa
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Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa
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Journal Article
Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa
2018
Overview
Background
Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant women living with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention of mother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examined adherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in the PMTCT programme in the Eastern Cape, South Africa.
Methods
This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. We conducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016. Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (
n
= 177) were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used to determine the independent predictors of ART non-adherence.
Results
A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, after adjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family member were the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the main reasons for non-adherence to ART.
Conclusions
Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated with lifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV, clinicians need to screen for these factors at every antenatal clinic visit.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Adult
/ Analysis
/ Anti-HIV Agents - adverse effects
/ Anti-HIV Agents - therapeutic use
/ Behavior
/ Diseases
/ Elimination of mother-to-child transmission
/ Female
/ Highly active antiretroviral therapy
/ HIV
/ HIV Infections - drug therapy
/ HIV Infections - transmission
/ Humans
/ Infant
/ Infectious Disease Transmission, Vertical - prevention & control
/ Medicine
/ Mothers
/ Patient Compliance - psychology
/ Patient Compliance - statistics & numerical data
/ Pregnancy Complications, Infectious - drug therapy
/ Pregnancy Complications, Infectious - psychology
/ Pregnancy Complications, Infectious - virology
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