Family Health International, Dar es salaam, Tanzania.
School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
PLoS One. 2019 Feb 22;14(2):e0212587. doi: 10.1371/journal.pone.0212587. eCollection 2019.
Adherence to option B+ antiretroviral treatment (ART) is vital to a successful implementation of Prevention of Mother to Child Transmission (PMTCT) program. Further studies show that optimal viral suppression is also crucial for a successful PMTCT program, however barriers to adherence exist and differ among populations and particularly within few years of its adoption in Tanzania. This study therefore aimed at investigating the level and predictors of adherence to ART option B+ among pregnant and lactating women in rural and urban settings of eastern Tanzania.
A cross-sectional study was conducted among 305 pregnant women and lactating mothers on Option B+ regime from six health facilities located in rural and urban settings in Morogoro region in eastern Tanzania. Data were collected using a structured questionnaire. Data analysis was performed using descriptive statistics, as well as bivariate and multivariate logistic regression.
Good adherence to option B+ PMTCT drugs was 26.3% and 61.1% among respondents residing in urban and rural areas respectively. The rural residents were 4.86 times more likely to adhere compared to their counterparts in an urban area (aOR = 4.86; 95% CI = 2.91-8.13). Similarly, women with male partners' support in PMTCT were 3.51 times more likely to have good adherence than those without (aOR = 3.51, 95% CI = 1.21-10.15). Moreover, there was a significantly lower odds of adherence to option B+ among those who had been on treatment between one to two years as compared to those had less than one year of treatment (aOR = 0.45; 95%CI = 0.22-0.93).
Adherence to PMTCT option B+ antiretroviral drugs treatment among pregnant women and breastfeeding mothers was low and much lower among urban residents. Adherence was significantly predicted by rural residence, male partner support and short duration on ART. Efforts to improve adherence should focus on increasing male participation on PMTCT, tailored interventions to urban residents and those who have been on ART for a long duration.
坚持使用 B+方案的抗逆转录病毒治疗（ART）对于成功实施预防母婴传播（PMTCT）项目至关重要。进一步的研究表明，最佳病毒抑制对于成功的 PMTCT 项目也至关重要，然而，坚持治疗存在障碍，并且在不同人群中存在差异，特别是在坦桑尼亚采用该方案后的几年内。因此，本研究旨在调查农村和城市环境中接受 B+方案的孕妇和哺乳期妇女对 ART 的依从性水平及其预测因素。
在坦桑尼亚东部莫罗戈罗地区的六个卫生机构中，对 305 名接受 B+方案的孕妇和哺乳期妇女进行了一项横断面研究。使用结构化问卷收集数据。使用描述性统计以及双变量和多变量逻辑回归进行数据分析。
在城市和农村地区，受访者对 B+PMTCT 药物的良好依从性分别为 26.3%和 61.1%。与城市地区的对应者相比，农村居民更有可能坚持治疗（aOR = 4.86；95%CI = 2.91-8.13）。同样，在 PMTCT 中得到男性伴侣支持的女性更有可能坚持治疗（aOR = 3.51，95%CI = 1.21-10.15）。此外，与治疗时间不到一年的人相比，治疗时间为一到两年的人坚持使用 B+方案的可能性显著降低（aOR = 0.45；95%CI = 0.22-0.93）。
孕妇和哺乳期妇女对 PMTCT B+方案抗逆转录病毒药物治疗的依从性较低，城市居民的依从性更低。农村居民、男性伴侣支持和接受 ART 治疗的时间长短显著预测了依从性。提高依从性的努力应侧重于增加男性参与 PMTCT、针对城市居民和接受 ART 治疗时间较长的人群制定针对性干预措施。
