PMID- 30574258
OWN - NLM
STAT- MEDLINE
DCOM- 20190103
LR  - 20240405
IS  - 1937-8688 (Electronic)
VI  - 30
DP  - 2018
TI  - Evaluation of non-adherence to anti-retroviral therapy, the associated factors 
      and infant outcomes among HIV-positive pregnant women: a prospective cohort study 
      in Lesotho.
PG  - 239
LID - 10.11604/pamj.2018.30.239.14532 [doi]
LID - 239
AB  - INTRODUCTION: Success in addressing prevention of mother-to-child transmission of 
      HIV depends largely on good adherence to anti-retroviral therapy (ART) by 
      pregnant women. Knowledge of the levels of ART adherence among pregnant women is 
      essential to inform strategies to prevent or reduce HIV transmission rates, 
      particularly in African settings. Aim: the primary objective of this study was to 
      measure adherence to anti-retroviral therapy (ART) among pregnant women living 
      with human immunodeficiency virus (HIV). The secondary objectives were to 
      determine: i) the rate of new infections among children at Mabote Filter Clinic 
      in Maseru, Lesotho whose mothers were enrolled in PMTCT, and ii) the factors 
      associated with non-adherence to ART among pregnant women. METHODS: In this 
      prospective cohort study, HIV-positive pregnant women receiving antiretroviral 
      therapy (ART) for prevention of mother to child transmission (PMTCT) were 
      followed up to delivery and their children were tested for HIV. We collected 
      socio-demographic information, knowledge of PMTCT and adherence to ART (three-day 
      recall and pill count) including reasons for non-adherence. We also used logistic 
      regression to explore factors associated with non-adherence. RESULTS: One hundred 
      and seven women were included. The mean (standard deviation) age of the 
      participants was 28.2 (5.7) years. Most, 81.3% (87/107), were married, only 9.3% 
      (10/107) had a postsecondary education. Two-thirds (63.6%: 68/107) of the 
      participants started ART because of PMTCT. Only 78.5% (84/107) of the 
      participants had adequate knowledge of the importance of PMTCT. The three-day 
      self-reported non-adherence rate at the first visit was 7.5% (95% confidence 
      interval (CI): 3.7, 13.1), but up to 43.4% (95% CI: 35.2, 51.9) using pill count. 
      The most frequently reported reasons for not adhering were: running out of pills 
      (7.5%), nausea (5.6%) and to avoid side-effects (3.7%). Women who were employed 
      (odds ratio (OR) 4.35; 95% CI: 1.38,14.29; p = 0.012) and at a higher gestational 
      age (OR = 1.43; 95% CI: 1.11, 1.85; p = 0.006) were more likely to be 
      non-adherent. Only 1 of the 77 exposed infants was found to be positive for HIV 
      at 6 weeks after birth. CONCLUSION: We found a higher non-adherence rate for 
      participants with pill count compared to a three-day adherence self-report. 
      However, mother to child HIV transmission was relatively low. Lack of employment 
      and relatively high gestational age were found to be predictive factors of 
      non-adherence.
FAU - Kadima, Ngomba
AU  - Kadima N
AD  - Queen Mamahato Memorial Hospital, Maseru, Lesotho-CTN International Postdoctoral 
      Fellow.
FAU - Baldeh, Tejan
AU  - Baldeh T
AD  - Department of Health Research Methods, Evidence and Impact McMaster University, 
      Hamilton, Canada.
FAU - Thin, Kyaw
AU  - Thin K
AD  - Research Coordination Unit, Room Number 326, Ministry of Health of Lesotho, 
      Maseru, Lesotho.
FAU - Thabane, Lehana
AU  - Thabane L
AD  - Department of Health Research Methods, Evidence and Impact McMaster University, 
      Hamilton, Canada.
AD  - Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's 
      Healthcare Hamilton, Hamilton, Ontario, Canada.
FAU - Mbuagbaw, Lawrence
AU  - Mbuagbaw L
AD  - Department of Health Research Methods, Evidence and Impact McMaster University, 
      Hamilton, Canada.
AD  - Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's 
      Healthcare Hamilton, Hamilton, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20180731
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/*administration & dosage
MH  - Cohort Studies
MH  - Employment/statistics & numerical data
MH  - Female
MH  - Gestational Age
MH  - HIV Infections/*drug therapy
MH  - Humans
MH  - Infant, Newborn
MH  - Infectious Disease Transmission, Vertical/prevention & control
MH  - Lesotho
MH  - Logistic Models
MH  - *Medication Adherence
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*drug therapy/virology
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC6295308
OTO - NOTNLM
OT  - Adherence
OT  - antiretroviral therapy
OT  - prevention of mother-to-child transmission
OT  - transmission
EDAT- 2018/12/24 06:00
MHDA- 2019/01/04 06:00
PMCR- 2018/07/31
CRDT- 2018/12/22 06:00
PHST- 2017/12/03 00:00 [received]
PHST- 2018/04/22 00:00 [accepted]
PHST- 2018/12/22 06:00 [entrez]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2019/01/04 06:00 [medline]
PHST- 2018/07/31 00:00 [pmc-release]
AID - PAMJ-30-239 [pii]
AID - 10.11604/pamj.2018.30.239.14532 [doi]
PST - epublish
SO  - Pan Afr Med J. 2018 Jul 31;30:239. doi: 10.11604/pamj.2018.30.239.14532. 
      eCollection 2018.