Adherence to PMTCT antiretroviral therapy among HIV infected pregnant women in Area W Clinic, Francistown Botswana
Thesis (MPhil)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: The purpose of this research was to determine the level of adherence among HIV infected pregnant women on prevention of mother to child transmission (PMTCT) antiretroviral therapy, and to establish the factors that contribute to poor adherence and their relative importance, in order to suggest intervention strategies that will improve treatment adherence among this population. The study was conducted in Area W Clinic, Francistown Botswana, and was a prospective cross sectional study using semi-structured questionnaire, and data collection form. In total, 61 pregnant women participated in the study and were all within three to nine months gestation, and had been enrolled into the PMTCT program at least more than one month previously. The following were their characteristics: 75% were within the ages of 26 to 42 years old, 90% were single, 81% had attained secondary school education, and 60% were unemployed. Adherence was considered optimum if greater than or equal to 95%. The participants demonstrated a good knowledge of the importance of PMTCT treatment adherence. Reported optimum adherence levels were 84% by virtual analogue assessment, and 82% by pill count. Ninety eight percent of participants reported they did not miss any dose during the last three days before the interview. The most important factors influencing adherence from the study were pregnancy related illnesses, medication side effects, and month of pregnancy of the patient as participants tended to adhere less as they got closer to delivery. It is therefore important for care-givers to carefully monitor patients for these effects, and to carry out continuous adherence counselling with special attention given to those approaching delivery in order to improve or maintain overall adherence to PMTCT therapy. In conclusion, adherence levels to PMTCT therapy among the population sampled was high but can be further enhanced with interventions designed to cover and improve the highlighted areas in the implementation of the preventive therapy.
AFRIKAANSE OPSOMMING: Altesaam 61 swanger vroue het deelgeneem aan hierdie studie, wat daarop uit was om getrouheid in antiretrovirale behandeling vir die voorkoming van moeder-na-kind-oordrag (PMTCT) van MIV te bepaal, vas te stel watter faktore tot swak behandelingsgetrouheid bydra sowel as watter relatiewe gewig aan elke faktor geheg kan word. Die einddoel was om intervensiestrategieë aan te beveel wat behandelingsgetrouheid onder die populasie van die kliniek in area W, Francistown, Botswana, sal verbeter. Dit blyk dat die deelnemers die belang van behandelingsgetrouheid verstaan: ’n Totaal van 84% het optimale getrouheidsvlakke van >95% deur middel van virtuele analoogassessering aangemeld, en 82% deur middel van ’n piltelling. Daarbenewens het 98% bevestig dat hulle in die drie dae voor die onderhoud geen medisynedosisse oorgeslaan het nie. Die beduidendste faktore wat behandelingsgetrouheid beïnvloed, is swangerskapsverwante siekte, newe-effekte van die medisyne sowel as die maand van swangerskap, aangesien getrouheid oënskynlik afneem namate die swangerskap vorder. Dus is dit belangrik om pasiënte deeglik hiervoor dop te hou en voortdurend berading met betrekking tot behandelingsgetrouheid te voorsien, met ’n bepaalde klem op diegene wie se bevalling nader kom, ten einde algehele PMTCT-behandelingsgetrouheid te verbeter of te handhaaf.