Adherence to Combination Antiretroviral Therapy among Pregnant Women Enrolled in a HIV Prevention Program in Rural North-central Nigeria.

Autor:	Calder CL; Meharry Medical College, School of Medicine, Department of Family and Community Medicine, Nashville, TN, USA., O'Hara H; Meharry Medical College, School of Medicine, Department of Family and Community Medicine, Nashville, TN, USA., Tabatabai M; Meharry Medical College, School of Graduate Studies and Research, Department of Biostatistics, Nashville, TN, USA., Maxwell CJ; Howard University Hospital, Department of Medicine, Washington, DC, USA., Marryshow S; Vanderbilt University Medical Center, Institute for Medicine and Public Health, Nashville, TN, USA., Ahonkhai AA; Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, Department of Medicine, Nashville, TN, USA., Audet CM; Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, Department of Health Policy, Nashville, TN, USA., Wester CW; Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, Department of Medicine, Nashville, TN, USA., Aliyu MH; Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, Department of Health Policy, Nashville, TN, USA.
Jazyk:	angličtina
Zdroj:	International journal of MCH and AIDS [Int J MCH AIDS] 2020; Vol. 9 (1), pp. 81-92. Date of Electronic Publication: 2020 Jan 12.
DOI:	10.21106/ijma.327
Abstrakt:	Objective: Adherence to combination antiretroviral therapy (ART) among pregnant women is essential to attaining the goal of eliminating mother-to-child HIV transmission. The objective of this study was to determine which factors affect adherence to ART among HIV-positive women enrolled in a large prevention of mother-to-child HIV transmission (PMTCT) trial in rural north-central Nigeria. Methods: The parent study included 372 HIV-positive pregnant women enrolled in a cluster-randomized control trial conducted at 12 health facilities in Nigeria between 2013 and 2015. This secondary analysis included HIV-positive women (and their infants) from the original trial with documented adherence data ( n =210, 56.5%). The primary outcome was maternal adherence to ART, determined by self-report and based on the visual analogue scale (VAS) of a validated medication adherence tool. Participants with a VAS score of ≥ 95% were classified as adherent. We employed multivariate logistic regression to evaluate the predictors of maternal ART adherence in the study sample. Results: Approximately 61.0% of study participants (128/210) were adherent to ART. The majority of adherent participants (62.5%, 80/128) were enrolled in the trial intervention arm. The most common cited response for non-adherence was fear of status disclosure. Adherence to ART was associated with study arm (intervention arm vs. control arm, adjusted Odds Ratio (aOR) [95% CI]: 16.95 [5.30-54.23]), maternal ethnicity (Gwari vs. Other, aOR = 0.13 [0.05-0.38]), and partner HIV status (HIV-positive vs. unknown, aOR = 3.14 [1.22-8.07]). Conclusion and Global Health Implications: Adherence to ART among a cohort of pregnant women enrolled in a PMTCT trial in rural North-Central Nigeria was associated with trial arm, maternal self-reported ethnicity, and partner's HIV status. Increased understanding of the interplay between these factors will enable the development of more targeted and effective interventions. Competing Interests: Conflicts of Interest: The authors declare no competing interests. (Copyright © 2020 Calder et al.)
Databáze:	MEDLINE
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