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Clinical Trial
. 2019 Feb 22;14(2):e0212587.
doi: 10.1371/journal.pone.0212587. eCollection 2019.

Low adherence to Option B+ antiretroviral therapy among pregnant women and lactating mothers in eastern Tanzania

Kamonga M Zacharius  1 , Namanya Basinda  2 , Karol Marwa  3 , Emmanuel H Mtui  4 , Albino Kalolo  5 , Anthony Kapesa  2
Affiliations
Clinical Trial

Low adherence to Option B+ antiretroviral therapy among pregnant women and lactating mothers in eastern Tanzania

Kamonga M Zacharius et al. PLoS One. .

Abstract

Background: Adherence to option B+ antiretroviral treatment (ART) is vital to a successful implementation of Prevention of Mother to Child Transmission (PMTCT) program. Further studies show that optimal viral suppression is also crucial for a successful PMTCT program, however barriers to adherence exist and differ among populations and particularly within few years of its adoption in Tanzania. This study therefore aimed at investigating the level and predictors of adherence to ART option B+ among pregnant and lactating women in rural and urban settings of eastern Tanzania.

Methodology: A cross-sectional study was conducted among 305 pregnant women and lactating mothers on Option B+ regime from six health facilities located in rural and urban settings in Morogoro region in eastern Tanzania. Data were collected using a structured questionnaire. Data analysis was performed using descriptive statistics, as well as bivariate and multivariate logistic regression.

Results: Good adherence to option B+ PMTCT drugs was 26.3% and 61.1% among respondents residing in urban and rural areas respectively. The rural residents were 4.86 times more likely to adhere compared to their counterparts in an urban area (aOR = 4.86; 95% CI = 2.91-8.13). Similarly, women with male partners' support in PMTCT were 3.51 times more likely to have good adherence than those without (aOR = 3.51, 95% CI = 1.21-10.15). Moreover, there was a significantly lower odds of adherence to option B+ among those who had been on treatment between one to two years as compared to those had less than one year of treatment (aOR = 0.45; 95%CI = 0.22-0.93).

Conclusion: Adherence to PMTCT option B+ antiretroviral drugs treatment among pregnant women and breastfeeding mothers was low and much lower among urban residents. Adherence was significantly predicted by rural residence, male partner support and short duration on ART. Efforts to improve adherence should focus on increasing male participation on PMTCT, tailored interventions to urban residents and those who have been on ART for a long duration.

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Conflict of interest statement

The authors have declared that no competing interests exit.

Figures

Fig 1
Fig 1. Reasons for not taking the option B+ ARVs for prevention of HIV transmission from mother to child among pregnant women and breast feeding mothers in eastern Tanzania.
See this image and copyright information in PMC

References

    1. Joint United Nations Programme for HIV/AIDS. UNAIDS data 2017 UNAIDS: Geneva, Switzerland: 2017.
    1. United Nations Programme on HIV/AIDS. Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive Joint United Nations Programme on HIV/AIDS (UNAIDS); 2011.
    1. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis. 2017.
    1. United Republic of Tanzania. Tanzania Elimination of mother to child transmission of HIV Plan, 2012–2015 Ministry of Health and Social welfare. Dar es Salaam: Ministry of Health and social welfare; 2016. p. 8–9.
    1. United Republic of Tanzania. National guidelines for comprehensive care services for prevention of mother to child transmission of HIV and keeping their mothers alive Ministry of Health and Social welfare. Dar es Salaam: Ministry of Health and Social welfare; 2013.

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