PMID- 28320347
OWN - NLM
STAT- MEDLINE
DCOM- 20171227
LR  - 20220410
IS  - 1471-2393 (Electronic)
IS  - 1471-2393 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Mar 21
TI  - Facilitators and barriers to uptake and adherence to lifelong antiretroviral 
      therapy among HIV infected pregnant women in Uganda: a qualitative study.
PG  - 94
LID - 10.1186/s12884-017-1276-x [doi]
LID - 94
AB  - BACKGROUND: In 2012, Uganda started implementing lifelong antiretroviral therapy 
      (ART) for prevention of mother to child transmission (PMTCT) in line with the WHO 
      2012 guidelines. This study explored experiences of HIV infected pregnant and 
      breastfeeding women regarding barriers and facilitators to uptake and adherence 
      to lifelong ART. METHODS: This was a cross-sectional qualitative study conducted 
      in three districts (Masaka, Mityana and Luwero) in Uganda, between February and 
      May 2014. We conducted in-depth interviews with 57 pregnant and breastfeeding 
      women receiving care in six health facilities, who had been on lifelong ART for 
      at least 6 months. Data analysis was done using a content thematic approach with 
      Atlas-ti software. RESULTS: Initiation of lifelong ART was done the same day the 
      mother tested HIV positive. Several women felt the counselling was inadequate and 
      had reservations about taking ART for life. The main motivation to initiate and 
      adhere to ART was the desire to have an HIV-free baby. Adherence was a challenge, 
      ranging from not taking the drugs at the right time, to completely missing doses 
      and clinic appointments. Support from their male partners and peer family support 
      groups enhanced good adherence. Fear to disclose HIV status to partners, drug 
      related factors (side effects and the big size of the tablet), and HIV stigma 
      were major barriers to ART initiation and adherence. Transition from antenatal 
      care to HIV chronic care clinics was a challenge due to fear of stigma and 
      discrimination. CONCLUSIONS: In order to maximize the benefits of lifelong ART, 
      adequate preparation of women before ART initiation and on-going support through 
      family support groups and male partner engagement are critical, particularly 
      after birth and cessation of breastfeeding.
FAU - Buregyeya, Esther
AU  - Buregyeya E
AD  - Department of Disease Control and Environmental Health, School of Public Health, 
      College of Health Sciences, Makerere University, Kampala, Uganda. 
      eburegyeya@musph.ac.ug.
FAU - Naigino, Rose
AU  - Naigino R
AD  - Department of Disease Control and Environmental Health, School of Public Health, 
      College of Health Sciences, Makerere University, Kampala, Uganda.
FAU - Mukose, Aggrey
AU  - Mukose A
AD  - Department of Epidemiology and Biostatics, School of Public Health, College of 
      Health Sciences, Makerere University, Kampala, Uganda.
FAU - Makumbi, Fred
AU  - Makumbi F
AD  - Department of Epidemiology and Biostatics, School of Public Health, College of 
      Health Sciences, Makerere University, Kampala, Uganda.
FAU - Esiru, Godfrey
AU  - Esiru G
AD  - AIDS Control Program, Ministry of Health, Kampala, Uganda.
FAU - Arinaitwe, Jim
AU  - Arinaitwe J
AD  - Global Fund Focal Coordination Office, Ministry of Health, Kampala, Uganda.
FAU - Musinguzi, Joshua
AU  - Musinguzi J
AD  - AIDS Control Program, Ministry of Health, Kampala, Uganda.
FAU - Wanyenze, Rhoda K
AU  - Wanyenze RK
AD  - Department of Disease Control and Environmental Health, School of Public Health, 
      College of Health Sciences, Makerere University, Kampala, Uganda.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170321
PL  - England
TA  - BMC Pregnancy Childbirth
JT  - BMC pregnancy and childbirth
JID - 100967799
SB  - IM
MH  - Adult
MH  - Breast Feeding/psychology
MH  - Cross-Sectional Studies
MH  - Disclosure
MH  - Female
MH  - HIV Infections/drug therapy/*psychology/transmission
MH  - Humans
MH  - Infectious Disease Transmission, Vertical/*prevention & control
MH  - Medication Adherence/*psychology
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/drug therapy/*psychology/virology
MH  - Pregnant Women/*psychology
MH  - Qualitative Research
MH  - Sexual Partners
MH  - Social Stigma
MH  - Social Support
MH  - Uganda
PMC - PMC5360052
EDAT- 2017/03/23 06:00
MHDA- 2017/12/28 06:00
PMCR- 2017/03/21
CRDT- 2017/03/22 06:00
PHST- 2015/07/30 00:00 [received]
PHST- 2017/03/14 00:00 [accepted]
PHST- 2017/03/22 06:00 [entrez]
PHST- 2017/03/23 06:00 [pubmed]
PHST- 2017/12/28 06:00 [medline]
PHST- 2017/03/21 00:00 [pmc-release]
AID - 10.1186/s12884-017-1276-x [pii]
AID - 1276 [pii]
AID - 10.1186/s12884-017-1276-x [doi]
PST - epublish
SO  - BMC Pregnancy Childbirth. 2017 Mar 21;17(1):94. doi: 10.1186/s12884-017-1276-x.