Factors associated with antiretroviral therapy adherence under option B+ strategy among breastfeeding mothers at Mzuzu Health Centre, Malawi
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Date
2020-09-01
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Abstract
ART adherence among breastfeeding mothers is very essential in the PMTCT. Standard adherence rate of ≥ 95% sufficiently suppresses the virus and brings much more desirable outcomes, thus; it improves maternal health and reduces rate of vertical transmission of HIV. However, PMTCT remains a challenge after childbirth, with inadequate adherence among the breastfeeding mothers which needs greater attention. The aim of the study was to investigate factors associated with ART adherence by specifically determining social-demographic factors, assessing patient related factors, identifying the therapy related factors, assessing condition related factors, determining health care system factors associated with ART adherence and determining ART adherence rate among breastfeeding mothers on option B+ strategy at Mzuzu Health Centre Malawi.
A quantitative cross-sectional descriptive study was conducted among all HIV positive mothers on ART with children breastfeeding from 6 weeks to 24 months, 18 years and above at Mzuzu Health Centre, Malawi in May to June 2019. Data were collected using a structured questionnaire (face to face interviews). A Statistical Package for Social Sciences (SPSS) version 23.0, bivariate and multivariate logistic regression was used for data analysis. A total of 323 participants were recruited in the study. The overall ART adherence rate among the breastfeeding mothers under option B+ strategy was 55.1%. The study showed that, forgetfulness [AOR 0.08; 95% CI :( 0.44, 0.14)], religious beliefs [AOR 0.49; 95% CI : (0.𝟤4, 1.0)], accessibility to ART clinic [AOR 2.53; 95% CI :( 1.13, 5.68)] and ART appointment dates [AOR 4.73; 95% CI :( 1.50, 14.98)], were significantly associated with ART adherence under patient related factors and health care system related factors respectively. The study showed that forgetfulness was the most significant variable which had the greatest effect on ART adherence rate. Therefore, efforts to improve ART adherence rate should focus on promoting strategies for reminders such as cell phones, alarm clocks and family members and other factors which showed significant association in ART adherence.