Factors Affecting Adherence to Antiretroviral Treatment Among HIV Positive Pregnant Women in the New Juaben Municipality

ABSTRACT

Background: Mother-to- Child Transmission (MTCT) of HIV is a global public health problem. Interventions in the prevention of mother to child transmission (PMTCT) programs have drastically reduced infant mortality associated with HIV/AIDS and new infections among babies born to mothers with HIV/AIDS. Scaling up the access and early initiation of antiretroviral treatment among pregnant women has been the pivot to this change. Adherence to the treatment is therefore an essential component to be emphasized when it comes to ARVs in the pregnant women. However, concerns are raised as to whether pregnant women religiously follow their medications. A number of factors have been identified to affect adherence to antiretroviral therapy. Interventions have also been put into place to improve upon adherence among HIV positive pregnant women. Objectives: The general objective was to assess the level of adherence to antiretroviral treatment among HIV positive pregnant women. The specific objectives were to determine the factors affecting adherence to antiretroviral treatment, and identify existing interventions to promote adherence to ARVs among pregnant women. Methods: The research was a cross sectional descriptive study that employed quantitative method. It was carried out at the New Juaben Municipality in two purposefully selected clinical areas (Koforidua Regional Hospital and Koforidua Polyclinic). The study used structured questionnaire to solicit for response. The statistical tool used was STATA version 13. Chi-square and Fisher’s exact tests were used to explore association between background factors and the categorized outcome of level of adherence computed from the Morisky-8 tool and pill count. Significant factors from this was used in multivariable logistic regression to adjust for the multiple factors. Findings: The study found out that, the adherence level of HIV positive pregnant women using three different adherence measuring tools were totally different. Again women who attend the PMTCT clinic at the polyclinic were more adherent compared with women at the Koforidua Regional Hospital. Interventions to improve on adherence is in place in both facilities. Social support is also available for those who have disclosed their status. In a multivariate analysis, factors like marital status, disclosure and amount of money spent, had no significant associations with adherence. Conclusion: The adherence level found in this study was generally low compared to other studies in different parts of the country. Comparing adherence level among respondents in the two facilities revealed that HIV positive pregnant women at the Koforidua polyclinic were more adherent than respondent from the Koforidua Regional Hospital. Factors revealed to have influence on adherence include pill burden, amount of money spent, distance and treatment support. Keywords: HIV/AIDS, adherence, ARVs, pregnant women, PMTCT