Determinants of Adherence to Option B+ Antiretroviral Therapy among Pregnant and Lactating Women Attending Public Hospitals in Dire Dawa and Harar, Ethiopia

Background: HIV infection among children accounts 30 % of the total new infection
in Ethiopia. To reduce pediatric HIV infection, antiretroviral drugs are
provided to all HIV positive pregnant and lactating mothers since 2013. The
effectiveness of such program is determined by mother’s adherence to the regimen,
which is indirectly influenced by socio-demographic and behavioral factors.
Therefore this study aimed at assessing the level and determinatesof option B+ Aantiretroviral Therapy (ART) adherence among pregnant
and lactating women attending public hospitals in Harar and Dire Dawa, Ethiopia,
2016.

Method: A facility based cross sectional study was conducted on 359 pregnant
and lactating women attending ART clinics at four public health facilities in
Harar and Dire Dawa cities, Eastern Ethiopia. Data were collected using
pretested, semi structured questionnaire and analyzed using SPSS version 16. Adequate
adherence for ART was determined if women took 25 pills and above per month. In
crude analysis, variables with p value less than 0.25 were kept in the final
adjusted analysis. Variables with p value less than 0.05 in final analysis were
considered significantly associated with the outcome variable.

Result: About 50 (16.4%) of participants were pregnant and the remaining were
lactating women. Antenatal care (ANC) attendance during pregnancy was reported
by 246 (80.9%) respondents. Good attitude on prevention of mother to child
transmission was reported by 189(62.2%). 
Adequate adherence was achieved by 251(82.6%) of study participants.
Women from urban (AOR= 4.1, 1.7-9.7), having ANC follow up (AOR= 3.8,
1.3-11.3), obtained husband support (AOR=2.7, 1.05-6.8), obtained ART
counseling (AOR=2.5, 1-6.3), having good attitude to PMTCT (AOR=2.4, 1-5.7)
were significantly associated with adequate adherence to option B+ ART
adherence.

Conclusion: A fifth of study participants don’t have adequate adherence. Factors
affecting adherence can be modified with adequate and proper counseling. Hence,
it is advisable to give due attention to the context of women to achieve high PMTCT
targets.