Infectious Diseases Institute (IDI) Collections

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Browsing Infectious Diseases Institute (IDI) Collections by Subject "Adherence"
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    Access to HIV/AIDS care for mothers and children in sub-Saharan Africa: adherence to the postnatal PMTCT program
    (Taylor & Francis (Routledge), 2009-09) Nassali, Mercy ; Nakanjako, Damalie ; Kyabayinze, Daniel ; Beyeza, Jolly ; Okoth, Anthony ; Mutyaba, Twaha
    Despite scale up of perinatal prevention of mother-to-child transmission (PMTCT) of HIV interventions,postnatal continuity of comprehensive HIV/AIDS care, for both the mother and baby, remains a challenge in developing countries. We determined adherence to the postnatal PMTCT program (PN-PMTCT) and the associated factors among mothers at a public urban hospital in Uganda. We interviewed HIV-positive postnatal mothers on discharge and we determined adherence to PN-PMTCT by the proportion of mothers that honored their return appointments by the end of eight weeks postpartum. We had focus group discussions to assess factors that influence adherence to PN-PMTCT. Of 289 mothers, only 110 (38%) adhered to PN-PMTCT. Previous attendance of a routine postnatal review and having access to a phone were significantly associated with adherence to PMTCT among mothers older than 25 years (odds ratio (OR) 3.6 (95% confidence interval (CI); 1.2 10.4)) and (OR 3.1 (95% CI; 1.3 7.1)), respectively. On the other hand, Christianity (OR 3.2 (95% CI; 1.1 9.0)) was significantly associated with adherence to PN-PMTCT among mothers below 25 years of age. Mothers’ perceived benefits of the PN-PMTCT program, easy access to the program, and presence of social support from a spouse were important motivators for mothers to adhere to PN-PMTCT. Even with improved antenatal and intra-partum PMTCT services, only a third of the HIV-infected mothers adhered to the PNPMTCT program. Mothers who previously attended a routine postnatal care were 3.6 fold more likely to adhere to PN-PMTCT. We recommend strategies to increase mothers’ adherence to PN-PMTCT interventions in order to increase access to HIV/AIDS care for mothers and children in sub-Saharan Africa.
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    Belief in divine healing can be a barrier to antiretroviral therapy adherence in Uganda
    (Lippincott Williams & Wilkins., 2007) Wanyama, Jane ; Castelnuovo, Barbara ; Wandera, Bonnie ; Mwebaze, Patricia ; Kambugu, Andrew ; Bangsberg, David R. ; Kamya, Moses R.
    Although recent data suggest high levels of adherence to expanding antiretroviral therapy (ART) programmes in resource-limited settings, the culture- specific barriers to adherence are poorly understood. In a prospective observational study, we found that 1.2% of patients discontinued ART because of a belief in spiritual healing. Spiritual beliefs should be an important part of ART adherence counselling in resource-limited settings, requiring close collaboration between HIV care programmes and religious leaders to identify common goals and ensure successful treatment.