Factors affecting adherence to antiretroviral therapy among pregnant women in theEastern Cape, South Africa
- Authors: Adeola, H A , Adeniyi, Oladele Vincent , Ajayi, Anthony Idowu , Goon, Daniel Ter , Owolabi, Eyitayo Omolara , Eboh, Alfred , Lambert, John
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5272 , vital:44427 , https://neuro.unboundmedicine.com/medline/citation/29653510/Factors_affecting_adherence_to_antiretroviral_therapy_among_pregnant_women_in_the_Eastern_Cape_South_Africa_
- Description: Background:Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant womenliving with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention ofmother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examinedadherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in thePMTCT programme in the Eastern Cape, South Africa.Methods:This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. Weconducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016.Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n= 177)were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used todetermine the independent predictors of ART non-adherence.Results:A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, afteradjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family memberwere the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the mainreasons for non-adherence to ART.Conclusions:Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated withlifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV,clinicians need to screen for these factors at every antenatal clinic visit.Keywords:Adherence, Non-adherence, HIV, Antiretroviral therapy, Elimination of mother-to-child transmission,Prevention of mother-to-child transmission, Stigma, South Africa
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- Date Issued: 2018
Beyond health care providers’recommendations: understandinginfluences on infant feeding choices ofwomen with HIV in the Eastern Cape,South Africa
- Authors: Adeniyi, Oladele Vincent , Ajayi, Anthony Idowu , Issah, Moshood , Owolabi, Eyitayo Omolara , Ter Goon, Daniel , Avramovic, Gordana , Lambert, John
- Date: 2017
- Subjects: Africa Infant Feeding Sub-sahara
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/6063 , vital:45109 , https://doi.org/10.1186/s13006-019-0201-5
- Description: Background: Despite the array of studies on infant feeding practices of HIV-infected women, gaps still exist in the understanding of the underlying reasons for their infant feeding choices. Potential for behavioural change exists, especially in the light of the 2016 updated World Health Organization guideline on HIV and infant feeding. The aim of this paper is to determine the rate of adoption of exclusive breastfeeding in this cohort, examine the determinants of infant feeding choices of HIV-infected women and assess the underlying reasons for these choices. Methods: This was a mixed methods study conducted between September 2015 and May 2016. It analyses the quantitative and qualitative data of 1662 peripartum women enrolled in the East London Prospective Cohort Study across three large maternity services in the Eastern Cape. Women with HIV reported their preferred choices of infant feeding. In addition, participants explained the underlying reasons for their choices. Descriptive and inferential statistics summarised the quantitative data, while thematic content analysis was performed on qualitative data. Results: Of the 1662 women with complete responses, 80.3% opted to exclusively breastfeed their babies. In the adjusted model, up to grade 12 education level (AOR: 1.81; 95% CI: 1.14, 2.86), rural/peri-urban residence (AOR:1.44; 95% CI: 1.05, 1.96), alcohol use (AOR: 1.65; 95% CI: 1.25, 2.18), negative or unknown HIV status at booking (AOR:1.85; 95% CI:1.27, 2.70), currently married (AOR:1.43; 95% CI:1.01, 2.02) and WHO Clinical Stage 2–4 (AOR:1.77; 95% CI: 1.15, 2.72) were significantly associated with the decision to exclusively breastfeed. Health care providers’ recommendations, perceived benefits of breastfeeding, unaffordability of formula feeding, and coercion were the underlying reasons for wanting to breastfeed; while work/school-related demands, breast-related issues, and fear of infecting the baby influenced their decision to formula feed. Conclusion: The majority of HIV-infected women chose to breastfeed their babies in the Eastern Cape. Following up on these women to ensure they breastfeed exclusively, while also addressing their possible concerns, could be an important policy intervention. Future studies should focus on how early infant feeding decisions change over time, as well as the health outcomes for mother and child. Keywords: Exclusive breastfeeding, Infant feeding practice, infant formula feeding, HIV-infected peripartum women, South Africa, WHO guideline
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- Date Issued: 2017