Abstract
BackgroundAdherence to Option B plus Antiretroviral Therapy plays a vital role in preventing mother to child transmission of Human Immunodeficiency Virus and development of drug resistance. This study was aimed to assess adherence to option B plus ART and associated factors among HIV positive pregnant women at public Hospitals in Southern Ethiopia.MethodsFacility based cross sectional study was conducted on HIV positive pregnant mothers attending public health facilities’ antenatal care unit. Systematic random sampling technique was employed to select 290 HIV positive pregnant women enrolled in the Option B plus program. Data were collected by using structured questionnaire. Bivariate and multivariable logistic regression analysis were used to identify factors associated with option B plus ART adherence. P-value less than 0.05 was considered as cut of point to declare statistical significance.ResultsThe overall adherence to option B plus ART among HIV positive pregnant women was 236 (81.4%). Three in twenty, (14.8%) participants were none adherent to Option B plus ART due to difficulty in adopting time schedule and forgetting to take medication. During first trimester of pregnancy, 16 (5.5%) were stopped taking ART medication due to side effects. Pregnant women who started ART at the time of HIV diagnosis [AOR = 1.99, 95% CI: (1.02, 3.95)], and who had five or more antenatal care visits [AOR = 4.10, 95% CI (1.65, 10.02)] were more likely to adhere to option B plus ART. Women who should travel 30–60 min on foot to access ART from service delivering facilities were less likely to adhere to option B plus [AOR = 0.39, 95% C I: (0.17, 0.88)].ConclusionsThe overall adherence to option B plus ART was suboptimal. Measures that improve recalling ability of individuals to take ART on time, and minimize ART side effects during first trimester of pregnancy need to be given emphasis. The study finding indicates the need for reconsidering the ad-hoc focused antenatal care visit at policy and program level by increasing the number of follow up visit with proper counseling on ART adherence benefits, and improving service accessibility.
Highlights
Adherence to Option B plus Antiretroviral Therapy plays a vital role in preventing mother to child transmission of Human Immunodeficiency Virus and development of drug resistance
Human immunodeficiency Virus (HIV) positive pregnant women who started Antiretroviral Therapy (ART) at the time of diagnosis were two times more likely to adhere to option B plus ART than mothers who were not started ART at the time of diagnosis [Adjusted Odd Ratio (AOR) = 1.99, 95% Confidence Interval (CI): (1.02, 3.95)]
Those participants who had five or more Antenatal Care (ANC) visits were four times more likely to adhere to option B plus ART than HIV positive pregnant women who had two antenatal visit [AOR = 4.10, 95% CI (1.65, 10.02)]
Summary
Adherence to Option B plus Antiretroviral Therapy plays a vital role in preventing mother to child transmission of Human Immunodeficiency Virus and development of drug resistance. Antiretroviral Therapy (ART) and other effective interventions for Prevention of Mother to Child Transmission (PMTCT) of HIV can reduce risk below 5% [1]. In 2013 World Health Organization (WHO) recommended Option B plus strategy to prevent mother to child HIV transmission [2]. Based on this strategy, soon after pregnant women’s HIV positive status was confirmed, a life-long triple Antiretroviral Therapy (ART) need to be offered regardless of their CD4 count and clinical stage [3]. In 2015 Mother to Child Transmission (MTCT) of HIV accounts for 90% of new cases among children
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