Factors Influencing Maternal Adherence to Infant’s Nevirapine Prophylaxis in a Cross-Sectional Study Conducted at Mulago Hospital, Kampala, Uganda

Abstract

To eliminate mother to child transmission of HIV, existing interventions might need to be scaled-up and rigorously implemented. One of the strategies to reduce vertical transmission of HIVis the 4-6weeks daily single oral dose ofNevirapine (NVP) or Zidovidinerecommended for newbornsto HIV positive mothers. Maternal optimal adherence to these anti-retroviral prophylaxis regimens is imperative to prevention of vertical transmission of HIV. Limited studies investigated maternal adherence to infant's NVP prophylaxis regimen and associated factors. This study examined the level and factors influencing maternal adherence to infant's NVPprophylaxis regimenat six weeks of age. Maternal adherence to infant's NVP regimen was defined as dispensation of 95% of the total daily single dose of NVPsuspension to infants at 6 weeks of age. Maternal adherence, socio-demographic and psychosocial factors were measured using a pre-tested questionnaire. Bivariate analysis and binary logistic regression model were used to determine the level and factors influencing maternal adherence to infant's NVP regimen respectively. Results showed that 77% of the mothers had optimal adherence. Maternal age ≥ 20 years and believe in the effectiveness of NVP in prevention of vertical transmission of HIV were associated with increased likelihood of adherence to infants NVP regimen (OR 6.18; 95% CI: 1.64-23.24) and (OR 12.69; 95% CI 3.07-52.44) respectively.In conclusion maternal maturity and perceived benefits of NVP seems to be important positive drivers of optimal adherence. This suggests the importance of considering psychosocial and demographic characteristics of mothers in policy and intervention designing.

Evaluation of an SMS-based mHealth intervention to enhance early infant diagnosis follow-up testing and assessment of postnatal prophylaxis

“…3,4,5 Efforts to decrease postnatal MTCT rates should be directed at maintaining a suppressed maternal VL through early ART initiation and ART adherence, together with adherence to infant ARV postnatal prophylaxis (PNP). High rates of poor adherence to maternal ART and PNP have been reported in Africa: infant PNP adherence rates range between 72.0% and 85.0% during the 6 weeks of nevirapine prophylaxis, 5,6,7 while in 2019 maternal ART adherence was reported at only 63.4%. 5 http://www.sajhivmed.org.za Open Access…”