Abstract

A. O. Igwegbe*, J. O. Ugboaja and L. A. Nwajiaku

Adherence to antiretroviral therapy (ART) is central to a successful prevention of mother- to- child transmission of HIV (PMTCT) programme by ensuring optimal viral suppression. However, barriers to adherence exist and differ among populations. This cross-sectional study was carried out among 368 HIVpositive pregnant mothers attending the PMTCT clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria to determine the prevalence and demographic variables related to non-adherence to ART. The mean age and parity of the women were 30.4 ± 4.4 years and 2.5 ± 2.0 respectively. Majority (97.0%) were married and had achieved secondary education and above (86.9%). One hundred and sixty five (44.8%) had been on ART for more than 2 years while 37.0 % commenced ART in the index pregnancy. The non adherence rate was 21.7%. The common reasons for missing ARV drugs were forgetfulness (63.8%); feeling healthy and hence no need to take ARV drugs (16.3%) and living very far from the hospital (15.0%) . Increasing maternal age (X2 = 13.6; P = 0.001), low educational level (X2 = 39.36 P = 0.002), extremes of parity (X2 = 11.3 P = 0.03), husband’s low educational level (X2 = 13.8; P = 0.01), being in a sero-concordant relationship (X2 = 6.2; P = 0.05) and non-disclosure of HIV serostatus (X2 = 12.96; P = 0.003) were significantly associated with non adherence to ART. Those women who had been on ART for up to 2 years and beyond (X2 = 9.52; P = 0.001), and those in whom the diagnosis of HIV was made before pregnancy (X2 = 5.21; P = 0.02) were more likely to be non -adherent to therapy. These factors are recommended to guide counseling and design of programmes aimed at reducing non-adherence to ART.