DETERMINANTS OF ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG PREGNANT WOMEN ACCESSING PREVENTION OF MOTHER TO CHILD TRANSMISSION SERVICES, ABAKALIKI EBONYI STATE, NIGERIA

Abstract

Globally Mother-to-child transmission (MTCT) of HIV accounts for over 90% of all pediatrics infection. High level of adherence to antiretroviral drugs is needed to achieve maximal reduction of transmission in pregnancy. The effect or poor adherence among patients is evidenced by rising numbers of HIV positive babies of mother on PMTCT Programme. The purpose of this research is to determine the level of adherence among HIV infected pregnant women on prevention of mother to child transmission (PMTCT) on antiretroviral therapy and to establish the factors that contribute to adherence. A cross sectional study was conducted in which (268) HIV positive pregnant women were recruited by systematic sampling method from PMTCT clinic of Federal Teaching Hospital Abakaliki. Pre tested interviewer administered questionnaire was used for data collection. Informational on socio-demographic characteristics, Knowledge of PMTCT, barriers to PMTCT and obstetric characteristics were obtained. Knowledge on PMTCT was accessed and a score of <4 out of 5 indicated poor knowledge. Adherence Level was calculated using the respondent self-report using (3 day recall) and a value < 95% indicated poor adherence. Data were analysed using descriptive statistics, Chi square and logistic regression (p ≤ 0.05). The mean age was 30.7± 4.2 years. Two hundred and nineteen (81.7%) of the respondents were married, 124 (46.3%) were traders and 141(52.6%) had secondary education. The prevalence of good adherence was 89.2% and 227(89.0%) had good knowledge of PMTCT. Fear of being identified as HIV positive(2 l % ) pregnancy related illness (13.7%) and forgetfulness (12.5%) were the most common reasons for non adherence. Partners support (OR=0.03, 95% Cl=0.01-0.09, P = 0.001), and Duration of ART (OR=4.39, 95% CI=1.3-14.5, P=0.019) were found to be significantly associated with good adherence at Bivariate analysis. However, after controlling for confounders, only Partner support (O=0.027, 95% CI=0.01-0.09, P<0.001) retained the association with good adherence. The study identified that stigmatisation and pregnancy related ilness was related to poor adherence while having Partners support improve adherence to HAART. Interventions simed at improving ART adherence in pregnancy should focus on these factors to guide ccouseling and to design programmes.