ObjectivesThis study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs.DesignAn observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI.SettingThe study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia.ParticipantsAbout 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study.Primary and secondary outcome measuresLevels of adherence to ART drugs and their associated factors.ResultsAmong 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm3 (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs.ConclusionsLevel of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.
Background
To promote the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS male partners play a significant role, especially in developing country were men’s are a decision maker in domestic activity. When men are involved in PMTCT it would boost the service utilization and uptake of ART drugs. Thus this systematic review and Meta analysis aims to assess importance of male partner involvement in prevention of mother to child transmission of HIV/AIDS in Ethiopia.
Methods
Studies were accessed through an electronic web-based search mechanism from PubMed, Advanced Google Scholar, WHO databases and journals (African Health Monitor, Pan African Journal of Public Health), using independent and combinations of key terms together with a reference list of included studies. Two reviewers independently screened and assessed the quality of studies based on pre-specified criteria. When a disagreement between the two reviewers happened; the third reviewer was invited and resolve it based on the stated objectives and inclusion criteria. Measures of effects were pooled and random effect meta analysis was conducted.
Results
Ten studies met the inclusion criteria. The pooled prevalence of male involvement in PMTCT was 31.8% (95% CI; 22.3–41.3 I2 = 98.4%, p = 0.00). being urban residence(AOR = 2.43 95%CI;1.42–4.18), partner knowledge (AOR = 2.84 95%CI;1.90–4.22), knowledge on Antenatal care(AOR = 3.5 95%CI;1.80–6.76), partners who had no negative perception towards for PMTCT (AOR = 3.21 95%CI;2.18–4.72), government employee(AOR = 2.57 95%CI;1.76–3.75), partners informed of need to go for PMTCT(AOR = 3.83 95%CI;1.88–7.79), health institution related barriers(AOR = 2.6 95%CI;1.882–3.622), primary (AOR = 2.21 95%CI;1.29–3.80), and secondary education(AOR = 2.67 95%CI;1.69–4.19) were significant factors related with male partner involvement in prevention of mother to child transmission of HIV/AIDS.
Conclusion
The proportion of male involvement in the Prevention of mother-to-child transmission of HIV in Ethiopia was low. Interventions aimed at improving male participation in the Prevention of mother-to-child transmission should consider the factors related to it. Healthcare services may need to be inclusive and could help men active engagement in PMTCT programs.
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