Adherence to Option B+ Care for the Prevention of Mother-to-Child Transmission Among Pregnant Women in Ethiopia

Abstract

Purpose: Even if progressive efforts were made in Ethiopia, half of new HIV infections result from mother-to-child transmission. Limited studies assessed the level and factors of adherence that differ among different populations across the country. So, this study aimed to investigate the level and predictors of adherence to the prevention of mother-to-child transmission (PMTCT) Option B⁺ care among pregnant women in central Ethiopia. Methods: A facility-based cross-sectional study design was conducted to interview 347 HIV positive pregnant women. Using a multistage sampling technique, participants were recruited from twelve health facilities based on probability proportional to the number of clients. The collected data on socio-demographics, healthcare delivery, clinical and individual factors were entered into EpiInfo v7.2.2.6, and further analysis was done using SPSS v23 software. Adherence was measured based on client self-report either as adherent and non-adherent. Bivariate and multivariate logistic regressions were undertaken to see the association between variables. Statistically significant variables were declared using an adjusted odds ratio with a 95% confidence interval. Results: The overall adherence to option B⁺ was 80.2% (95% CI: 76.3– 84.5%). Time of ART initiation (AOR=3.23; 95% CI: 1.09– 6.59), fear of stigma for taking ARV (AOR=5.06; 95% CI: 1.79– 10.26), ANC appointment (AOR=4.62; 95% CI: 1.48– 6.42), male partner support (AOR=2.23; 95% CI: 1.11– 4.50), and counseling (AOR=5.36: 95% CI: 1.00– 8.58) were the associated factors with level of adherence. Conclusion: The overall adherence level to Option B⁺ care in this study was inadequate to suppress the viral load during pregnancy. The result revealed that keeping adherence to ARVs during pregnancy is still challenging. So, all concerned bodies need to give attention to minimize the barriers from the client, environment, and health system perspectives.