Belachew Tegegne Wale, Erega Besfat Berihun, Ewunetu Mesafint, Gelaye Kihinetu, Yimer Tigist Seid, Ferede Wassie Yazie
Department of Midwifery College of Medicine and Health Sciences, Debre Tabor University, Ethiopia.
Department of Midwifery College of Medicine and Health Sciences, Bahir Dar University, Ethiopia.
Heliyon. 2024 Jul 26;10(15):e35319. doi: 10.1016/j.heliyon.2024.e35319. eCollection 2024 Aug 15.
Adherence to Option B+ antiretroviral medication (ART) is essential for the successful implementation of the Prevention of Mother-to-Child Transmission (PMTCT) program. However, poor adherence to Option B + PMTCT drugs among women results in increased viral load and mother-to-child transmission and reduces immunological and clinical outcomes.
The objective of the study was to assess the level of Option B plus drug adherence for preventing mother-to-child transmission of HIV and associated factors among HIV positive women in selected government health facilities of Awi zone, Amhara region, Northwest Ethiopia,2020.
This institutional-based cross-sectional study was conducted from March 1 to April 30 among 358 HIV-positive women (pregnant and lactating mothers). A multistage sampling procedure was used to select the study participants. Data were collected using a structured questionnaire through interviews. The collected data were entered into EPI Data 3.1 statistical software for data management and analyzed using SPSS version 25 statistical package. The associations between variables were analyzed using bivariate and multivariable logistic regression models. A p-value ≤0.05 at the 95 % confidence interval was considered statistically significant.
Out of the 358 participants, adherence to Option B + PMTCT was 83.24 %. The study revealed that counselling [AOR = 4.4, 95 % CI: 1.60-12.29], partner support involvement [AOR = 3.0, 95 % CI: 1.17-7.92], and time taken to reach from home to the facility [AOR = 3.1, 95 % CI: 1.51-6.52] were significantly associated with the level of adherence to Option B + PMTCT.
This study showed that the level of Option B + PMTCT drug adherence was lower than the nationally recommended adherence level. Good counselling, partner support, and reduced travel time from home to the facility were associated with adherence to Option B + PMTCT drugs. Therefore, counselling is crucial for increasing adherence to Option B + PMTCT drugs. Accessible health facilities reduce travel burdens, encourage regular clinic visits, and enhance adherence to PMTCT drugs. Partners can provide reminders, attend appointments, offer emotional support, and explore alternatives such as mobile clinics or medication delivery services.
坚持使用B+方案抗逆转录病毒药物（ART）对于成功实施预防母婴传播（PMTCT）计划至关重要。然而，女性对B+方案PMTCT药物的依从性差会导致病毒载量增加和母婴传播，并降低免疫和临床效果。
本研究的目的是评估2020年在埃塞俄比亚西北部阿姆哈拉地区阿维区选定的政府卫生设施中，HIV阳性女性预防母婴传播的B+方案药物依从性水平及相关因素。
本研究为基于机构的横断面研究，于3月1日至4月30日对358名HIV阳性女性（孕妇和哺乳期母亲）进行。采用多阶段抽样程序选择研究参与者。通过访谈使用结构化问卷收集数据。收集的数据输入EPI Data 3.1统计软件进行数据管理，并使用SPSS 25版统计软件包进行分析。使用双变量和多变量逻辑回归模型分析变量之间的关联。在95%置信区间，p值≤0.05被认为具有统计学意义。
在358名参与者中，B+方案PMTCT的依从率为83.24%。研究表明，咨询[AOR = 4.4，95%CI：1.60 - 12.29]、伴侣支持参与[AOR = 3.0，95%CI：1.17 - 7.92]以及从家到医疗机构的时间[AOR = 3.1，95%CI：1.51 - 6.52]与B+方案PMTCT的依从水平显著相关。
本研究表明，B+方案PMTCT药物的依从水平低于国家推荐的依从水平。良好的咨询、伴侣支持以及减少从家到医疗机构的时间与B+方案PMTCT药物的依从性相关。因此，咨询对于提高B+方案PMTCT药物的依从性至关重要。可及的卫生设施减轻了出行负担，鼓励定期门诊就诊，并提高了对PMTCT药物的依从性。伴侣可以提供提醒、陪同就诊、给予情感支持，并探索替代方案，如流动诊所或药物配送服务。
