Adherence to Antiretroviral Treatment for Prevention of Mother-to-Child Transmission of HIV in Eastern Ethiopia: A Cross-Sectional Study

Introduction: Even though PMTCT (prevention of mother-to-child transmission) is the most effective option to prevent vertical transmission of HIV, achieving optimal adherence has been a universal challenge to PMTCT, including Ethiopia. Objective: To assess levels of adherence and associated factors among pregnant and lactating mothers on PMTCT at public health facilities in Harar town, Harari region, Eastern Ethiopia. Methods: A facility-based cross- sectional study was conducted from April 01 to April 30, 2019, at the selected public health facilities of Harar town, Harari regional state, Eastern Ethiopia. Adherence was measured using a multi-method tool that includes pill counting and self-reporting method. Binary logistic regression analysis was used to determine factors associated with PMTCT adherence. The results were adjusted for possible confounding variables and P- value <0.05 or CI not including 1 was considered statistically significant. Results: Of the 190 included patients, 83.2% of them had good adherence to PMTCT. Forgetfulness (79%) and being busy (71%) were among the main reasons for nonadherence to PMTCT. In multivariate logistic regression, participants who have received counseling on side effects were 3.4 times more likely to have good adherence [AOR=3.4, 95% CI: 2.1-9.2]; those with previously known HIV status were 2.1 times more likely to have good adherence to PMTCT [AOR=2.1, 95% CI: 1.6-7.1] and women who were knowledgeable on PMTCT were 5.2 times more likely to have good adherence [AOR= 5.2, 95% CI: 1.6- 6.28]. Conclusion: In this study, the overall level of adherence to PMTCT care and support was 83.2%. Counseling on side effects, knowledge about PMTCT, and pregnancy status during initiation of ART were the factors that determine adherence of pregnant and lactating women towards PMTCT service. Thus, it is recommended to raise awareness about PMTCT among all reproductive-age women by stressing the benefit of the early initiation of ART and by providing information on the possible side effect of the drugs.