Challenges in PMTCT antiretroviral adherence in northern KwaZulu-Natal, South Africa

Bibliographic Data

ID19443389
AuthorsStephen Mepham (University of KwaZulu-Natal, corresponding author), Zanele Zondi (University of KwaZulu-Natal), A Mbuyazi (University of KwaZulu-Natal), N Mkhwanazi (University of KwaZulu-Natal), Nompumelelo P Mkhwanazi (0000-0002-0808-9201, University of KwaZulu-Natal), Marie-Louise Newell (0000-0002-1074-7699, University College London), M L Newell (University of KwaZulu-Natal)
Year2011
Volume23
Issue6
Pages741-747
Publication date2011-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2010.516341
PMID21293987
OpenAlexW1975238748
LanguageEN
Citations received37
References cited11

BACKGROUND: Women living with HIV in sub-Saharan Africa face significant challenges in accessing HIV care and adhering to antiretroviral therapy. Most reports have focused on issues relating to long-term adherence such as those surrounding stigma and disclosure, hunger, cultural factors, lack of accurate health information, lack of social support, medication side effects and overcrowded health systems. Information related to the challenges facing pregnant women when taking antiretrovirals for prophylactic purposes is limited. The "Kesho Bora Study" is a multicentre prevention of mother-to-child transmission (PMTCT) trial in sub-Saharan Africa evaluating the PMTCT efficacy of triple therapy until cessation of breast feeding compared to short course zidovudine monotherapy in a predominantly breast feeding population. Following unexplained discrepancies during objective adherence assessments, a sub-study was conducted at one site to examine the underlying adherence issues. METHODS: The counselling and clinical notes of all 100 enrolled Zulu women were examined. Extracted information was supplemented by unstructured, free-ranging interviews conducted by trained adherence counsellors on 43 consecutive women attending the trial clinic over a two-week period. Adherence was defined as good (>95% adherence), or poor (<95% adherence). RESULTS: Reasons provided for sub-optimal adherence included therapy misconceptions/misunderstandings, antiretroviral use by relatives, domestic violence, poverty and issues relating to disclosure and stigma. About 61% (57/94) of antenatal women had good adherence with their PMTCT prophylaxis, with no significant difference shown between those taking the long and short course. CONCLUSION: Antenatal women in northern rural KwaZulu-Natal face significant challenges in taking antiretroviral PMTCT prophylaxis

Antiretroviral therapy · Developing country · Environmental health · Family medicine · Population · Poverty · Psychiatry · Social stigma · Viral load · Biological Research and Disease Studies · HIV/AIDS Research and Interventions · Medicine · Mobile Health and mHealth Applications · Pediatrics