Exploring barriers to antiretroviral therapy adherence among pregnant women: A scoping literature review

Abstract

Background Antiretroviral therapy (ART) is one of the most effective ways of preventing HIV‐related maternal mortality. However, the rates of retention in care and long‐term adherence remain extremely low. Objective The aim of this study was to explore barriers to antiretroviral therapy adherence among pregnant women. Search strategy The search for articles was conducted using EBSCO Host, PubMed, Google scholar, and Cumulative Index of Nursing and Allied Health Literature (CINAHL). Selection criteria The studies included were conducted between 2000 and 2020 and covered barriers to antiretroviral therapy. Data collection and analysis Data was collected from 8 selected articles and analyzed using Arksey and O’Malley five stages framework. Main results Barriers to antiretroviral therapy adherence included side effects of the therapy and financial constraints limiting access to food, transport, and medication. Other barriers included cultural and religious factors, lack of spouse support, stigma, and discrimination. Conclusion There is need to support pregnant women undergoing antiretroviral therapy to mitigate barriers associated with the uptake of the therapy.

Coincidental discovery of HIV and pregnancy positive status in primary healthcare facilities

“…HIV is one of the major public health problems, especially in developing countries, accounting for approximately 12% of maternal deaths during pregnancy and 2% during postpartum (Arias-Colmenero et al 2020 ; Kalungwe et al 2022 ). Africa is the most affected region worldwide, where most of the population including pregnant women is currently being treated with antiretroviral therapy (Arias-Colmenero et al 2020 ).…”

“…Antiretroviral therapy was found to be the most effective way to reduce HIV-related maternal mortality and perinatal transmission of HIV (Moseholm et al 2022 ). HIV-positive pregnant women among other worries face poor adherence to ART, as a result, this affects the progress in the fight against maternal mortality (Kalungwe et al 2022 ). Despite these benefits, pregnant women must also cope with stressors that are affecting their health (Moseholm et al 2022 ).…”

Enhanced Peer-Group strategies to support prevention of Mother-to-Child HIV transmission leads to increased retention in care in Uganda: A Randomized controlled trial

“…Despite this progress and the proven efficacy of Option B+ (5), poor adherence to lifelong ART and low retention in care of pregnant and postpartum women living with HIV has remained an important programmatic challenge to the implementation of Option B+ especially in low resource settings (6)(7)(8)(9)(10)(11). A review of studies done between 2000-2020 identified barriers to taking ART among pregnant women that included financial constraints limiting access to food and transport, and side effects of the therapy (12). Additionally, high dropout rates from PMTCT care have been documented after delivery and at two years of follow-up among mothers living with HIV (13)(14)(15), suggesting that service integration and linking mothers to routine ART services were important determinants of retention in care.…”

A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia

“…A literature review showed that many factors influence the likelihood that pregnant women with HIV receive proper ARV treatment. Kalungwe et al [ 8 ] showed that, in Africa, factors related to side effects and financial constraints in accessing food, transportation, and medicines influenced adherence to ARV treatment. Other factors included culture, religion, lack of partner support, stigma, and discrimination.…”