Factors influencing adherence to antiretroviral therapy among women initiated on treatment during antenatal care clinic in Kampala District

Abstract

Introduction: Transmission of HIV from an infected woman to the child contributes about 18% of new HIV infections in Uganda. In the bid to prevent this transmission, Uganda has adopted new PMTCT guidelines where all HIV positive pregnant women are initiated on ART. To ensure success of this intervention, MoH has endeavored to provide free ART to women on PMTCT programme though adherence to the treatment is at large a challenge. Hence the study was assessing factors influencing adherence to ART among women initiated on treatment, during ANC in Kampala district. Methods: The was a descriptive and analytical cross-sectional study design, employing quantitative and qualitative methods. The study was carried out in all eight public health centres at level III and IV where PMTCT services are provided. The study population was HIV positive women initiated on ART during ANC and systematic sampling was used. Univariate, bivariate multivariate analyses were carried using Stata for quantitative analysis. Eight IDI and four KII were conducted with women enrolled on ART during pregnancy and PMTCT focal personnel. Results: Of all respondents, 45.7% had high adherence. Enabling factors associated with adherence of women who were having large scale business, residing in place not more than 5km and having received counseling on previous visit. Reasons for low adherence included non-disclosure of HIV status, side effects, inadequate counseling and poor knowledge on MTCT. Recommendations: Strategies are needed to improve the level of adherence through increasing the number of counselors in public health facilities. Women should be encouraged to disclose their HIV status to the people they stay with. HIV related stigma should be addressed through community sensitisation. There is need to improve economic status of women living with HIV.