Adherence to ART among pregnant women living with HIV/AIDS in Lusaka Urban

Abstract

Introduction Adherence to ART is a challenge among pregnant women living with HIV/AIDS. This has an effect on the health of the mother and the unborn child. While studies have been done, it has shown that adherence during pregnancy is a challenge. Ensuring adherence to the prescribed ART continues to be a major Public Health concern in both high income and low income countries. Virological and clinical success depend critically on high adherence to ART because with low adherence the virus quickly develops therapy limiting drug resistance, which may lead to the usage of second line treatment which is very expensive, and sometimes not available. With non-availability of second line treatment there has been maternal disease progression and risk of Vertical Mother to Child Transmission (MTCT). Promoting adherence to ART among pregnant women living with HIV/AIDS requires an understanding of potential factors that influence adherence and this study explored how interventions can be developed in order to address this low level of adherence to ART among pregnant women living with HIV/AIDS. This study was carried out to determine factors that influence adherence to antiretroviral therapy among HIV positive pregnant women in Lusaka district of Zambia.

Methodology This was a qualitative study which used a case study approach. Data was collected through in-depth interviews. The collected data as was analysed using a thematic analytical approach.

Results 17 out of 30 among pregnant women living with HIV /AIDS in Lusaka had Challenges with adherence to ART. The study explained factors related to adherence to ART among pregnant women living with HIV/AIDS. ART adherence was found to be low and reasons for low adherence to ART among pregnant women were divided into threats that included Economical factors( lack of food), Physical factors ( Drug side effects), Environmental factors ( long waiting hours with long queues) and social stigma. The findings call for the need to improve on food programs, improve on drug regimens, improve on staffing levels at the health facility in order to reduce on long waiting hours and long queues and reduce on social stigma. The results confirmed that there is low adherence to ART among pregnant women living with HIV /AIDS in Lusaka, and they also confirm that adherence to ART among pregnant women is a big challenge.

Conclusion Adherence to ART among pregnant women living with HIV/AIDS is a challenge for Zambian pregnant women. Improved levels of adherence to ART is hampered by fear of social stigma, Drug side effects, lack of food and fear of being blamed by partners if they disclosed their status. Stigmatisation needs to be addressed because nearly all the participants expressed this factor. There is need to address the HIV/AIDS stigma very seriously in order for society to look at HIV/AIDS like any other illness. The success of this strategy will depend on careful consideration of the barriers and enablers to pregnant women’s access to and use of ART. Managing these barriers and enhancing known enablers will require the development of respectful and locally acceptable HIV and ANC service delivery models, that are responsive to women’s needs and perspectives, and support them as they enter and move through the maternal ART cascade. It will also require better understanding of the ways women live outside the clinic affect their chances of entering into, and staying adherent to and retained in care.