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Multicenter Study
. 2018 Apr 13;18(1):175.
doi: 10.1186/s12879-018-3087-8.

Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa

Oladele Vincent Adeniyi  1 , Anthony Idowu Ajayi  2 , Daniel Ter Goon  3 , Eyitayo Omolara Owolabi  3 , Alfred Eboh  4 , John Lambert  5
Affiliations
Multicenter Study

Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa

Oladele Vincent Adeniyi et al. BMC Infect Dis. .

Abstract

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.

Keywords: Adherence; Antiretroviral therapy; Elimination of mother-to-child transmission; HIV; Non-adherence; Prevention of mother-to-child transmission; South Africa; Stigma.

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Conflict of interest statement

Ethics approval and consent to participate

The Walter Sisulu University Ethics Committee approved the study. Participants gave written consent and the study was conducted by respecting the right of participants to privacy, anonymity and confidentiality. We obtained parental consent for three participants below 16 years, who assented to participate in the study.

Competing interests

The authors declared that they had no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Reasons for Non-adherence among pregnant women on ART
See this image and copyright information in PMC

References

    1. Broder S. The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antivir Res. 2010;85(1):1–18. doi: 10.1016/j.antiviral.2009.10.002. - DOI - PMC - PubMed
    1. Bor J, Herbst AJ, Newell M-L, et al. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science. 2013;339(6122):961–965. doi: 10.1126/science.1230413. - DOI - PMC - PubMed
    1. Antiretroviral Therapy Cohort Collaboration Mortality of HIV-infected patients starting potent antiretroviral therapy: comparison with the general population in nine industrialized countries. Int J Epidemiol. 2009;38(6):1624. doi: 10.1093/ije/dyp306. - DOI - PMC - PubMed
    1. Ndirangu J, Newell M-L, Tanser F, et al. Decline in early life mortality in a high HIV prevalence rural area of South Africa: evidence of HIV prevention or treatment impact? AIDS (London, England) 2010;24(4):593. doi: 10.1097/QAD.0b013e328335cff5. - DOI - PMC - PubMed
    1. Bhardwaj S, Treger-Slavin L, Barron P, et al. Elimination of mother-to-child transmission of HIV in South Africa: rapid scale-up using quality improvement: prevention of mother-to-child transmission-progress towards the millennium development goals. S Afr Med J. 2014;104(3):239–243. doi: 10.7196/SAMJ.7605. - DOI - PubMed

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