OPTION B+ ANTIRETROVIRAL ADHERENCE AMONG HIV POSITIVE PREGNANT WOMEN: A MULTICENTER CROSS SECTIONAL STUDY IN SOUTH ETHIOPIA

Background: There is a claim with Option  B+  PMTCT,  as there  is  prolonged  exposure  to  ART, may lead  to  difficulties  in  adhering  to  treatment  for  HIV-positive pregnant  women. Adherence to ART is vital to achieve the goal “HIV free generation”. This study was aimed to assess option B+ PMTCT adherence and its associated factors among HIV positive pregnant women enrolled at PMTCT program in public hospitals of south Ethiopia. Method and materials: A hospital based cross sectional study was conducted from May to September/2016 in ART clinics of seven hospitals found in south Ethiopia. A total of 290 pregnant women enrolled in the Option B+ PMTCT programme were selected using systematic random sampling. Data were collected using structured questioner and entered in to Epi info version 3.5.1 software; and analyzed by using SPSS version 20 statistical software. Bivariate and multivariate logistic regression analysis methods were used to identify factors associated with option B+ PMTCT adherence. P-value less than 0.05 were used as cut of point to declare statistical significance. Result: The overall option B+ PMTCT adherence level of the participants was 236 (81.4%). Among non-adhered participants, 14.8% were due to difficulty in remembering to take medication and 5.9% were taking a break from ART medication. HIV positive pregnant women who are not started ART at the time of diagnosis [AOR=2.04, 95 % CI: (1.12, 4.11)] and who had five and above ANC visit [AOR=5.83, 95% CI (1.29, 26.41)] were more likely to adhere to option B+ PMTCT. Participants who traveled 30-60 minute to reach health facility were less to adhere to option B+ PMTCT [AOR= 0.40, 95 % C I: (0.18, 0.91)]. Conclusion and recommendation: Majority of the study participants had good adherence level. Under option B+ strategy, all pregnant women living with HIV are offered life-long ART, regardless of their CD4 count. In this study, however, participants who started ART at the time of diagnosis were found to have less adherence level. Strengthening the current antenatal care by making the health facilities more accessible to HIV positive pregnant needs an attention. Further study on starting time of ART and adherence is forwarded.