Adherence to option B+ PMTCT program and its predictors among HIV-positive women in Ethiopia. A systematic review and meta-analysis

Habtamu Geremew; Demeke Geremew; Samuel Abdisa; Anteneh Mengist Dessie; Getachew Mullu Kassa; Nurilign Abebe Moges

doi:10.1002/hsr2.1404

Adherence to option B+ PMTCT program and its predictors among HIV-positive women in Ethiopia. A systematic review and meta-analysis

Health Sci Rep. 2023 Jul 5;6(7):e1404. doi: 10.1002/hsr2.1404. eCollection 2023 Jul.

Authors

Habtamu Geremew¹, Demeke Geremew², Samuel Abdisa¹, Anteneh Mengist Dessie³, Getachew Mullu Kassa⁴, Nurilign Abebe Moges⁴

Affiliations

¹ College of Health Sciences Oda Bultum University Chiro Ethiopia.
² Department of Medical Laboratory Sciences, Immunology and Molecular Biology Unit, College of Medicine and Health Sciences Bahir Dar University Bahir Dar Ethiopia.
³ Department of Public Health, College of Health Sciences Debre Tabor University Debre Tabor Ethiopia.
⁴ Department of Public Health, College of Health Sciences Debre Markos University Debre Markos Ethiopia.

Abstract

Background: Previously, few studies investigated level of adherence to option B+ lifelong antiretroviral therapy (ART) in Ethiopia. However, their findings were inconsistent. Therefore, this review aimed to determine the pooled magnitude of adherence to option B+ lifelong ART and its predictors among human immune virus (HIV)-positive women in Ethiopia.

Methods: A comprehensive web-based search was conducted using PubMed, Cochrane Library, Science Direct, Google scholar, and African Journals Online databases to retrieve relevant articles. STATA 14 statistical software was used to carry out the meta-analysis. We used the random effects model to account for the large heterogeneity across included studies. Egger's regression test in conjunction with funnel plot and I ² statistics were utilized to assess publication bias and heterogeneity among included studies respectively.

Result: Twelve studies with a total of 2927 study participants were involved in this analysis. The pooled magnitude of adherence to option B+ lifelong ART was 80.72% (95% confidence interval [CI]: 77.05-84.39; I ² = 85.4%). Disclosure of sero-status (OR 2.58 [95% CI: 1.55-4.3]), receiving counseling (OR 4.93 [95% CI: 3.21-7.57]), attending primary school and above (OR 2.45 [95% CI: 1.31-4.57]), partner support (OR 2.24 [95% CI: 1.11, 4.52]), good knowledge about prevention of mother-to-child transmission (PMTCT) (OR 4.22 [95% CI: 2.02-8.84]), taking less time to reach health facility (OR 1.64 [95% CI: 1.13-2.4]), and good relation with care provider (OR 3.24 [95% CI: 1.96-5.34]) were positively associated with adherence. Whereas, fear of stigma and discrimination (OR 0.12 [95% CI: 0.06-0.22]) and advanced disease stage (OR 0.59 [95% CI: 0.37-0.92]) were negatively associated.

Conclusion: The level of adherence to option B+ lifelong ART was suboptimal. Strengthened comprehensive counseling and client education on PMTCT, HIV status disclosure, and male partner involvement are important to eliminate mother to child transmission and control the pandemic.

Keywords: Ethiopia; HIV‐positive women; adherence; option B+.