Author:
Fassinou Lucresse Corine,Songwa Nkeunang Diane,Delvaux Thérèse,Nagot Nicolas,Kirakoya-Samadoulougou Fati
Abstract
Abstract
Background
To assess the adherence to option B + antiretroviral therapy (ART) and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa (SSA).
Methods
We conducted a comprehensive search from 01st January 2012 to 03rd October 2022, across four databases: PubMed, Scopus, Proquest Central, and Index Medicus Africain, to identify studies focused on pregnant and/or breastfeeding women living with HIV and receiving option B+ ART in SSA. Studies reporting adherence data were included in the meta-analysis. Were excluded studies published before 01st January 2012, grey literature, systematic reviews, and meta-analysis studies. Articles selection and data extraction were performed independently by two reviewers. We evaluated pooled adherence and pooled association between various factors and adherence using a random-effects model.
Results
Overall, 42 studies involving 15,158 participants across 15 countries contributed to the meta-analysis. The overall pooled adherence was 72.3% (95% CI: 68.2–76.1%). Having high education level (pooled odds ratio (OR): 2.25; 95% CI: 1.57–3.21), living in urban area (pooled OR: 1.75; 95% CI: 1.10–2.81), disclosing status to a family/partner (pooled OR: 1.74; 95% CI: 1.27–2.40), having a support system (pooled OR: 3.19; 95% CI: 1.89–5.36), receiving counseling (pooled OR: 3.97; 95% CI: 2.96–5.34), initiating ART at early clinical HIV stage (pooled OR: 2.22; 95% CI: 1.08–4.56), and having good knowledge on PMTCT/HIV (pooled OR: 2.71; 95% CI: 1.40–5.25) were factors significantly associated with adherence to option B + ART.
Conclusions
Despite the implementation of option B+ ART, the level of adherence among pregnant and breastfeeding women in SSA falls short of meeting the critical thresholds for viral load suppression as outlined in the 95-95-95 objectives set for 2025. These objectives are integral for achieving HIV elimination, and in turn, preventing HIV mother-to-child transmission. To bridge this gap, urgent tailored interventions based on individual and structural factors are essential to enhance adherence within these subgroups of women. This targeted approach is crucial in striving towards the HIV elimination target in SSA.
Funder
Académie de Recherche et d’Enseignement Supérieur
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference84 articles.
1. World Health Organization. Mother-to-child transmission of HIV. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv. Accessed 22 Nov 2022.
2. UNAIDS. 2015 progress report on the global plan: toward the elimination of new infections among children and keeping their mothers alive. 2015. Available on: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv. Accessed 22 Nov 2022.
3. UNAIDS. Women and girls carry the heaviest HIV burden in sub-Saharan Africa. Available on: https://www.unaids.org/en/resources/presscentre/featurestories/2022/march/20220307_women-girls-carry-heaviest-hiv-burden-sub-saharan-africa. Accessed 22 Nov 2022.
4. UNICEF. Elimination of mother-to-child transmission: Progress in reducing new HIV infections among children has stagnated in recent years. 2023. Available on: https://data.unicef.org/topic/hivaids/emtct/. Accessed 9 Mar 2023.
5. WHO/UNAIDS/UNICEF. The Global Alliance to end AIDS in children. Available on: https://www.unaids.org/sites/default/files/media_asset/global-alliance-end-AIDS-in-children_en.pdf. Accessed 9 Mar 2023.