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Meta-Analysis
. 2024 Apr 25;19(4):e0298119.
doi: 10.1371/journal.pone.0298119. eCollection 2024.

Level of adherence to option B+ program and associated factors among HIV-positive women in Ethiopia: A systematic review and meta-analysis

Alemu Degu Ayele  1 , Bekalu Getnet Kassa  1 , Gedefaye Nibret Mihretie  1 , Habtamu Gebrehana Belay  1 , Dagne Addisu Sewyew  1 , Abenezer Melkie Semahegn  1 , Enyew Dagnew Yehuala  1 , Gebrehiwot Ayalew Tiruneh  1 , Lebeza Alemu Tenaw  2 , Abrham Debeb Sendekie  3 , Adanech Getie Teffera  1 , Eden Workneh Aychew  1 , Yismaw Yimam Belachew  4 , Tewachew Muche Liyeh  1 , Mulugeta Dile Worke  1
Affiliations
Meta-Analysis

Level of adherence to option B+ program and associated factors among HIV-positive women in Ethiopia: A systematic review and meta-analysis

Alemu Degu Ayele et al. PLoS One. .

Abstract

Background: Despite policy initiatives and strategic measures highly focused on preventing mother-to-child transmission through the implementation of the Option B+ program, adherence to the treatment is still challenging. The level of adherence and determinants of Option B+ program utilization reported by different studies were highly inconsistent in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the pooled prevalence of adherence to the Option B+ program and its predictors among HIV-positive women in Ethiopia.

Methods: PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were searched for published articles from March 2010 to March 2022. The pooled prevalence of adherence was estimated using a weighted DerSimonian-Laird random effect model. The I2 statistics was used to identify the degree of heterogeneity. Publication bias was also assessed using the funnel plot and Egger's regression test.

Results: A total of 15 studies were included. The pooled estimate of the option B+ program among HIV-positive women in Ethiopia was 81.58% (95% CI: 77.33-85.84). Getting social and financial support (AOR = 3.73, 95% CI: 2.12, 6.58), disclosure of HIV status to partners (AOR = 2.05, 95% CI: 1.75, 2.41), time to reach a health facility (AOR = 0.33, 95% CI: 0.16, 0.67), receiving counseling on drug side effects (AOR = 4.09, 95% CI: 2.74, 6.11), experience of drug side effects (AOR = 0.17, 95% CI: 0.08, 0.36), and knowledge (AOR = 4.73, 95% CI: 2.62, 8.51) were significantly associated with adherence to the Option B+ program.

Conclusion: This meta-analysis showed that the level of adherence to the Option B+ program in Ethiopia is lower than the 95% level of adherence planned to be achieved in 2020. Social and financial support, disclosure of HIV status, time to reach the health facility, counseling, drug side effects, and knowledge of PMTCT were significantly associated with option B+ adherence. The findings of this meta-analysis highlight that governmental, non-governmental, and other stakeholders need to design an effective strategy to scale up the level of disclosing one's own HIV status, access health facilities, improve knowledge of PMTCT, and counsel the potential side effects of Option B+ drugs, and advocate the program to reduce the multidimensional burden of HIV/AIDS.

Trial registration: Prospero registration: CRD42022320947. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320947.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study selection for systematic review and meta-analysis of the level of adherence to the option B+ program among women in Ethiopia.
Fig 2
Fig 2. Forest plot of the pooled prevalence of level of adherence to the option B+ program among HIV-positive women in Ethiopia.
Fig 3
Fig 3
a: Funnel plot to test the publication bias of 15 studies. b: Results of the trim and fill analyses for adjusting the publication bias of the 16 studies.
Fig 4
Fig 4. Factors affecting the level of adherence to the option B+ program among HIV-positive women in Ethiopia.
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References

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