Abstract
BackgroundIn 2013, Zambia accepted the immediate operationalization of Option B+, a policy used to try and eliminate mother to child transmission. This policy requires all HIV-positive pregnant and breastfeeding women to initiate antiretroviral treatment for life regardless of CD4 count. However, not all HIV positive women accept treatment for life. This study aimed to investigate acceptability of lifelong ART (Option B+) among HIV positive women receiving antenatal and postnatal services at the university teaching hospital and Lusaka urban city clinics.MethodsThis was a cross sectional study conducted in November, 2016 to March 2017. The study population comprised of HIV positive women in their reproductive age (15–49 years). A Structured questionnaire was used to collect data in a face to face interview with the participants. Data was entered in EpiData version 3.1 and analysed using Stata version 13. Multivariate logistic regression analysis was performed to determine predictors of acceptability.ResultsOverall, 427 women participated in this study. Their mean age was 30 years. Of the 427, over half (54%) had inadequate knowledge and about 30% of the women in the study still experience stigma and discrimination.63.2% of the women had good attitude towards Option B+ and overall, the majority (77.8%) were willing to accept antiretroviral therapy for life. Multivariate analysis showed that only women with good attitude were 9.4 times more likely to accept Option B+ than those with a bad attitude [OR: 9.4: 95%CI, 5.8–15.2)].ConclusionThis study showed that in general, women accepted initiation of Option B+. However, there is still a gap in the level of knowledge of Option B+ as well as stigma and discrimination in some communities, hence there is need to intensify programs that are aimed at educating the community on the importance of ART for life, combat stigma and discrimination and consequently promote acceptability of Option B+.
Highlights
In 2013, Zambia accepted the immediate operationalization of Option B+, a policy used to try and eliminate mother to child transmission
The study showed that over half (54.1%) of the participants had inadequate knowledge of Option B+. These findings were consistent with a study conducted in Tanzania which showed inadequate knowledge on treatment and prevention for Human immunodeficiency virus (HIV) infected pregnant women: only 34% knew that HIV-infected pregnant woman could be on antiretroviral therapy (ART) and 47% did not know that antiretroviral (ARVs) should be used throughout life [7]
This study revealed that about 30% of the women still experience HIV related stigma and discrimination from their partners and families which may affect the acceptability of life-long treatment
Summary
In 2013, Zambia accepted the immediate operationalization of Option B+, a policy used to try and eliminate mother to child transmission. This policy requires all HIV-positive pregnant and breastfeeding women to initiate antiretroviral treatment for life regardless of CD4 count. Progress in reducing mother-to-child transmission of HIV has been dramatic since the introduction in 2011 of the ‘Global Plan towards the Elimination of New HIV Infections among Children, and Keeping their Mothers Alive’, largely because of increased access to PMTCT-related services and increased number of pregnant women living with HIV being initiated on lifelong antiretroviral medicines [1]. Under Option A, women received antenatal and intrapartum antiretroviral prophylaxis along with an antiretroviral postpartum “tail” regimen to reduce risk of drug resistance, while infants receive postpartum antiretroviral prophylaxis throughout the duration of breastfeeding [2]
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