Wondimu Fikadu, Yetwale Fisseha, Admassu Endashew, Binu Wakgari, Bulto Gizachew Abdissa, Lake Getie, Girmaye Eden, Temesgen Kababa, Marama Taklu
Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
HIV AIDS (Auckl). 2020 Nov 19;12:769-778. doi: 10.2147/HIV.S282463. eCollection 2020.
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.
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.
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.
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.
尽管埃塞俄比亚不断做出努力，但仍有一半的新增艾滋病病毒感染是母婴传播所致。有限的研究评估了该国不同人群中依从性的水平及影响因素。因此，本研究旨在调查埃塞俄比亚中部地区孕妇对预防母婴传播（PMTCT）方案B治疗的依从性水平及其预测因素。
采用基于机构的横断面研究设计，对347名感染艾滋病病毒的孕妇进行访谈。运用多阶段抽样技术，根据与客户数量成比例的概率，从12家医疗机构招募参与者。将收集到的社会人口统计学、医疗服务、临床和个体因素数据录入EpiInfo v7.2.2.6，并使用SPSS v23软件进行进一步分析。依从性根据客户自我报告分为依从和不依从进行测量。采用双变量和多变量逻辑回归分析变量之间的关联。使用调整后的比值比和95%置信区间来确定具有统计学意义的变量。
方案B的总体依从率为80.2%（95%CI：76.3-84.5%）。开始抗逆转录病毒治疗的时间（调整后比值比=3.23；95%CI：1.09-6.59）、对服用抗逆转录病毒药物的耻辱感（调整后比值比=5.06；95%CI：1.79-10.26）、产前检查预约（调整后比值比=4.62；95%CI：1.48-6.42）、男性伴侣的支持（调整后比值比=2.23；95%CI：1.11-4.50）以及咨询（调整后比值比=5.36：95%CI：1.00-8.58）是与依从性水平相关的因素。
本研究中方案B治疗的总体依从水平不足以在孕期抑制病毒载量。结果表明，孕期坚持服用抗逆转录病毒药物仍然具有挑战性。因此，所有相关机构需要从客户、环境和卫生系统的角度关注减少障碍。
