Option B plus antiretroviral therapy adherence and associated factors among HIV positive pregnant women in Southern Ethiopia

Abstract

Background: 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. 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.

Methods: Facility 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.

Results: The 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)].

Conclusions: The 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.

Keywords: Adherence; Antiretroviral therapy; Option B plus; Pregnant women.

Fig. 1

Option B plus adherence level by knowledge of HIV status during PMTCT enrolment and timing of ART initiation among HIV positive pregnant women in Southern Ethiopia, 2017. The X-axis represents status of ART initiation at HIV diagnosis; the Y-axis represents percent of adherence level; the left column shows women diagnosed for HIV at another pregnancy, the middle column shows women newly diagnosed for HIV during current pregnancy, and the right column represents women who knew their HIV positivity in non-pregnancy period