Department of Epidemiology, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
BMC Pregnancy Childbirth. 2019 Feb 28;19(1):82. doi: 10.1186/s12884-019-2228-4.
Adherence to Option B plus Antiretroviral Therapy plays a vital role in preventing mother to child transmission of Human Immunodeficiency Virus and development of drug resistance. This study was aimed to assess adherence to option B plus ART and associated factors among HIV positive pregnant women at public Hospitals in Southern Ethiopia.
Facility based cross sectional study was conducted on HIV positive pregnant mothers attending public health facilities' antenatal care unit. Systematic random sampling technique was employed to select 290 HIV positive pregnant women enrolled in the Option B plus program. Data were collected by using structured questionnaire. Bivariate and multivariable logistic regression analysis were used to identify factors associated with option B plus ART adherence. P-value less than 0.05 was considered as cut of point to declare statistical significance.
The overall adherence to option B plus ART among HIV positive pregnant women was 236 (81.4%). Three in twenty, (14.8%) participants were none adherent to Option B plus ART due to difficulty in adopting time schedule and forgetting to take medication. During first trimester of pregnancy, 16 (5.5%) were stopped taking ART medication due to side effects. Pregnant women who started ART at the time of HIV diagnosis [AOR = 1.99, 95% CI: (1.02, 3.95)], and who had five or more antenatal care visits [AOR = 4.10, 95% CI (1.65, 10.02)] were more likely to adhere to option B plus ART. Women who should travel 30-60 min on foot to access ART from service delivering facilities were less likely to adhere to option B plus [AOR = 0.39, 95% C I: (0.17, 0.88)].
The overall adherence to option B plus ART was suboptimal. Measures that improve recalling ability of individuals to take ART on time, and minimize ART side effects during first trimester of pregnancy need to be given emphasis. The study finding indicates the need for reconsidering the ad-hoc focused antenatal care visit at policy and program level by increasing the number of follow up visit with proper counseling on ART adherence benefits, and improving service accessibility.
坚持使用“Option B plus 抗逆转录病毒疗法”对于预防母婴传播人类免疫缺陷病毒和耐药性的产生至关重要。本研究旨在评估埃塞俄比亚南部公立医院接受 Option B plus 抗逆转录病毒治疗的 HIV 阳性孕妇对该方案的坚持程度和相关因素。
采用基于机构的横断面研究，对在公立卫生机构产前保健单位就诊的 HIV 阳性孕妇母亲进行研究。采用系统随机抽样技术选择 290 名参加 Option B plus 方案的 HIV 阳性孕妇。使用结构化问卷收集数据。采用双变量和多变量逻辑回归分析来确定与 Option B plus ART 坚持相关的因素。p 值小于 0.05 被认为具有统计学意义。
HIV 阳性孕妇总体上坚持 Option B plus ART 的比例为 236（81.4%）。有三分之一（14.8%）的参与者因难以遵守时间表和忘记服药而不坚持 Option B plus ART。在妊娠早期，有 16（5.5%）人因副作用而停止服用 ART 药物。在 HIV 诊断时开始接受 ART 治疗的孕妇 [比值比（AOR）= 1.99，95%置信区间（CI）：（1.02，3.95）]，以及接受了 5 次或以上产前保健就诊的孕妇 [AOR = 4.10，95% CI（1.65，10.02）]，更有可能坚持使用 Option B plus ART。需要步行 30-60 分钟才能到达提供 ART 服务的地点的妇女，不太可能坚持使用 Option B plus [AOR = 0.39，95% CI：（0.17，0.88）]。
总体而言，坚持使用 Option B plus ART 的情况并不理想。需要采取措施，提高个人按时服药的记忆能力，减少妊娠早期的 ART 副作用。研究结果表明，需要在政策和方案层面重新考虑临时性、重点关注的产前保健就诊，增加随访次数，提供适当的 ART 坚持益处咨询，并改善服务的可及性。
