FACTORS INFLUENCING ADHERENCE TO OPTION B+ AMONG HIV POSITIVE PREGNANT AND LACTATING MOTHERS

TABLE OF CONTENTS

ABSTRACT................................................................................................................... i COPYRIGHT................................................................................................................ ii

AUTHORIZATIONS ..................................................................................................iii DEDICATION............................................................................................................. iv ACKNOWLEDGEMENT.............................................................................................v

TABLE OF CONTENTS............................................................................................. vi

LIST OF TABLES....................................................................................................... xi

LIST OF ABBREVIATIONS..................................................................................... xii

DEFINITIONS OF TERMS...................................................................................... xiii

CHAPTER ONE: INTRODUCTION........................................................................... 1

1.1 Background of the study ..........................................................................................1

1.2 Problem statement....................................................................................................3

1.3 Purpose of the study.................................................................................................4

1.4 Specific objectives...................................................................................................4

1.5 Research questions...................................................................................................4

1.6 Justification of the study ..........................................................................................4

CHAPTER TWO: LITERATURE REVIEW................................................................5

2.1 Introduction..............................................................................................................5

2.2 Knowledge of the mothers on adherence to option B+ among HIV positive mothers...........................................................................................................................6

2.3 Socio-economic factors influencing adherence to option B+ among HIV positive mothers...........................................................................................................................7

2.4 Hospital related factors influencing adherence to option B+ among HIV positive mothers...........................................................................................................................8

CHAPTER THREE: METHODOLOGY ....................................................................11

3.1 Introduction............................................................................................................11

3.2 Study design and rationale.....................................................................................11

3.3 Study setting and rationale.....................................................................................12

3.4 Study population ....................................................................................................12

3.4.1 Sample size determination predict......................................................................13

3.5 Inclusion and exclusion criteria .............................................................................14

3.5.1 Inclusion criteria .................................................................................................14

3.5.2 Exclusion criteria ................................................................................................14

3.6 Study variables.......................................................................................................15

3.6.1 Dependent variable .............................................................................................15

3.6.2 Independent variables .........................................................................................15

3.7 Research instruments.............................................................................................15

3.8 Data collection procedures.....................................................................................15

3.9 Data analysis and presentation...............................................................................16

3.11 Limitations of the study .......................................................................................16

3.12 Dissemination of the results.................................................................................17

CHAPTER FOUR: RESULTS ....................................................................................18

4.1 Introduction............................................................................................................18

4.2 Demographic data of the participants....................................................................18

4.3 Knowledge on adherence to option B+ among HIV positive mothers..................20

4.4 Socio-economic factors influencing adherence to option B+……………………22

4.5 Hospital related factors influencing adherence to option B+.................................23

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION...26

5.1 Discussion............................................................................................................. 26

5.1.1 Demographic data of the participants.................................................................26

5.2.2 Knowledge on adherence to option B+ among HIV positive mothers...............27

5.2.3 Socio-economic factors influencing adherence to option B+.............................28

5.2.4 Hospital related factors influencing adherence to option B+..............................29

5.3 Conclusion ............................................................................................................ 31

5.4 Recommendation. ................................................................................................. 32  

5.5 Implications to nursing......................................................................................... 33  

REFERENCES ............................................................................................................34

APPENDICES .............................................................................................................39

Appendix I: Consent Form...........................................................................................39

Appendix II: Questionnaire..........................................................................................40

Appendix III: Letter of Approval.................................................................................44

Appendix IV: Map of Uganda showing location of Rakai district ..............................45

Appendix V: Map of Rakai district showing location of Kalisizo hospital.................46

ABSTRACT

Globally, 30-45% of infants born to HIV-positive mothers become infected during pregnancy, child birth and breastfeeding due to poor ARV adherence. Therefore, the purpose of the study was to determine factors influencing adherence to option B+ among HIV positive pregnant and lactating mothers at Kalisizo hospital, Rakai district. A descriptive cross-sectional study and quantitative methods of data collection was used. 58 mothers were selected by purposive sampling technique. Data collected using well- structured questionnaire was analyzed using Microsoft excel and word. 90% of the mothers knew the meaning of adherence to option B+. 60%did not adhere to EMTCT drugs as 49% lacked transport, 20% were fearing people, 20% were feeling a healthy state and 9% reported forgetfulness, while the least2% missed drugs while away from home. 52% reported that EMTCT/Option B+ helps to prevent HIV transmission to babies. Major socio-economic factor was transport challenge as 69% used >2000/= and74% used Bodaboda. 84% moved 6KM or more from home and 57% could wait for services for over 4 hours. Although 59% were satisfied with the health staff assistance and the overall rate towards the quality of services was good, still, study findings revealed poor adherence due to the above factors. Emphasis on intensive adherence counseling to HIV-positive pregnant and lactating mothers is needed to improve on adherence. Advising them on income-generating activities is needed to enable them to earn some money.