Medication adherence in HIV-positive pregnant women on antiretroviral therapy attending antenatal clinics in Ado metropolis, south-west Nigeria: A multicentre study

Background. Adherence to antiretroviral therapy (ART) and optimal viral suppression are crucial to the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS.  Objective. To determine adherence to ART and associated factors in Ado-Ekiti, Nigeria.  Methods. A cross-sectional multicentre study was conducted among 170 HIV-positive pregnant women attending antenatal clinics of Ekiti State University Teaching Hospital and the Comprehensive Health Centre in Ado-Ekiti. Data collected using a semi-structured questionnaire were analysed with SPSS. Descriptive statistics, univariate and logistic regression were performed to determine factors associated with good adherence.  Results. Using the pill count method and the Morisky Medication Adherence Scale-8 (MMAS-8), the prevalence of good adherence was 73.5% and 75.3%, respectively. Women with higher education were three times more likely to practise good adherence than those with little or no formal education (adjusted odds ratio (aOR)=3.03; 95% confidence interval (CI) 1.23 - 5.79; p =0.043) and those employed were four times more likely to practise good adherence (aOR=4.13; 95% CI 1.83 - 8.15; p =0.02). Also, partner disclosure, treatment support and use of ARVs for prevention of mother-to-child transmission (PMTCT) were indications of women three times more likely to practise good adherence ((aOR=2.53; 95% CI 0.99 - 5.80; p =0.035); (aOR=2.15; 95% CI 0.77 - 4.15; p =0.014) and (aOR=3.15; 95% CI 0.93 - 6.21; p =0.035)). Forgetfulness, busy schedule and stigmatisation were reasons given for non-adherence.  Conclusions. The majority of the women had good adherence. However, counselling on adherence and partner disclosure should be sustained to ensure full benefits of PMTCT.