Antiretroviral therapy adherence among peripartum women with HIV in Kenya
An explanatory mixed methods study using dry blood spot measures and narrative interviews
Bibliographic Data
Adherence to antiretroviral therapy (ART) remains sub-optimal among pregnant and postpartum women with HIV (PPWH) in high HIV prevalence low resource settings with few effective behavioral interventions. A large body of qualitative literature has established general barriers and facilitators to ART adherence in PPWH at various levels (individual, interpersonal, structural). However, research exploring the underlying behavioral mechanisms of ART adherence in PPWH with objectively verified adherence biomarkers is extremely limited. We conducted 24 in-depth interviews with postpartum women in western Kenya who had linked ART drug concentrations obtained from three dried blood spot samples across the peripartum period. Among PPWH with a low drug concentration (n = 13) compared to those with continuously high drug concentrations (n = 11), distinct themes emerged related to HIV status disclosure, social support, interactions with the health system, and health beliefs. By combining ART biomarkers with patient reported challenges, there is the potential for real-time interventions to support sustained ART adherence among PPWH and improve maternal and infant health outcomes
Antiretroviral therapy · Biology · Dried blood spot · Family medicine · Interpersonal communication · Narrative · Obstetrics · Postpartum period · Pregnancy · Psychiatry · Psychological intervention · Qualitative research · Viral load · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology
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