Prevalence and Factors Associated with Fixed-Dose Combination Antiretroviral Drugs Adherence among HIV-Positive Pregnant Women on Option B Treatment in Mpumalanga Province, South Africa

Int J Environ Res Public Health. 2018 Jan 20;15(1):161. doi: 10.3390/ijerph15010161.

Abstract

The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers' adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected at 12 community health centres, over 12 months (2014-2015), from 673 HIV-positive women, less than 6 months pregnant, attending antenatal care, and on Option B treatment. Adherence measures included the Adults AIDS Clinical Trials Group (AACTG) four-day measure, as well as the Visual Analog Scale (VAS) seven-day measure. Bivariate analyses and multivariate logistic regressions are presented. 78.8% of respondents were adherent on AACTG, while 68.8% reported VAS adherence. Bivariate analyses for increased adherence show significant associations with older age, less/no alcohol usage, disclosure of HIV status, higher HIV knowledge, no desire to avoid ARV side effects, low stigma, and low depression. AACTG showed a negative association with intimate partner violence. Multivariable logistic regression on AACTG and VAS adherence rates resulted in unique contributions to increased adherence of older age, less/no alcohol usage, higher HIV knowledge, lack of depression, and non-disclosure. Programs targeting closer side effect monitoring, HIV disclosure, pre-natal depression, alcohol intake, and HIV knowledge need consideration.

Keywords: ARVs; HIV/AIDS; Option B; adherence; pregnant.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Cross-Sectional Studies
  • Drug Therapy, Combination*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • HIV Infections / transmission
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Pregnancy
  • Pregnant Women*
  • Prevalence
  • Social Stigma
  • South Africa / epidemiology