Determinants of Treatment Adherence and Retention in Care among HIV Positive Pregnant and Breastfeeding Women in a Rural District in Zimbabwe

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DOI: 10.21522/TIJPH.2013.07.04.Art032

Authors : Addmore Chadambuka, Nicholas Midzi


Background: A preliminary review of St Albert’s Mission Hospital data showed 15% of HIV positive pregnant and breastfeeding women (PPBW) missed drug pick-up appointments and 10% were lost to follow up. This affects Zimbabwe reaching 90% viral suppression target among those on antiretroviral therapy and increases HIV transmission risk to unborn fetus or breastfeeding infant. We determined factors associated with treatment adherence and retention in care among PPBW.

Methods: We conducted a cross-sectional analytic study among PPBW receiving care at the hospital. Women were sampled consecutively on presenting for antenatal or postnatal care. We used interviewer administered questionnaire to elicit information from consenting PPBW. We obtained ethical approval and written informed consent from PPBW.

Results: We interviewed 120 PPBW. The majority were breastfeeding women (60.0%). Over 95% PPBW disclosed their HIV status. The majority used this hospital because the health workers treated them with respect (66.7%), maintained client confidentiality (75.0%) and had good relations with their clients (70.8%). Skipping medication because of travel (adjusted odds ratio (AOR) 95% confidence interval (CI) 0.06 (0.005-0.79 and having an unpleasant experience while seeking care AOR (95% CI) 0.05 (0.002-0.93) were independently associated with lower medication adherence. Disclosure to avoid hiding taking medication AOR (95% CI) 22.07 (1.64-297.66 and attending this hospital because the health workers maintain confidentiality AOR (95% CI) 22.07 (1.64-297.66) were independently associated with higher retention in care.

Conclusion: Health system factors play an important role in adherence and retention of pregnant and breastfeeding women attending care at this facility


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