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Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study.
BMC Pregnancy Childbirth. 2017 03 21; 17(1):94.BP

Abstract

BACKGROUND

In 2012, Uganda started implementing lifelong antiretroviral therapy (ART) for prevention of mother to child transmission (PMTCT) in line with the WHO 2012 guidelines. This study explored experiences of HIV infected pregnant and breastfeeding women regarding barriers and facilitators to uptake and adherence to lifelong ART.

METHODS

This was a cross-sectional qualitative study conducted in three districts (Masaka, Mityana and Luwero) in Uganda, between February and May 2014. We conducted in-depth interviews with 57 pregnant and breastfeeding women receiving care in six health facilities, who had been on lifelong ART for at least 6 months. Data analysis was done using a content thematic approach with Atlas-ti software.

RESULTS

Initiation of lifelong ART was done the same day the mother tested HIV positive. Several women felt the counselling was inadequate and had reservations about taking ART for life. The main motivation to initiate and adhere to ART was the desire to have an HIV-free baby. Adherence was a challenge, ranging from not taking the drugs at the right time, to completely missing doses and clinic appointments. Support from their male partners and peer family support groups enhanced good adherence. Fear to disclose HIV status to partners, drug related factors (side effects and the big size of the tablet), and HIV stigma were major barriers to ART initiation and adherence. Transition from antenatal care to HIV chronic care clinics was a challenge due to fear of stigma and discrimination.

CONCLUSIONS

In order to maximize the benefits of lifelong ART, adequate preparation of women before ART initiation and on-going support through family support groups and male partner engagement are critical, particularly after birth and cessation of breastfeeding.

Authors+Show Affiliations

Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. eburegyeya@musph.ac.ug.Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.Department of Epidemiology and Biostatics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.Department of Epidemiology and Biostatics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.AIDS Control Program, Ministry of Health, Kampala, Uganda.Global Fund Focal Coordination Office, Ministry of Health, Kampala, Uganda.AIDS Control Program, Ministry of Health, Kampala, Uganda.Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28320347

Citation

Buregyeya, Esther, et al. "Facilitators and Barriers to Uptake and Adherence to Lifelong Antiretroviral Therapy Among HIV Infected Pregnant Women in Uganda: a Qualitative Study." BMC Pregnancy and Childbirth, vol. 17, no. 1, 2017, p. 94.
Buregyeya E, Naigino R, Mukose A, et al. Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study. BMC Pregnancy Childbirth. 2017;17(1):94.
Buregyeya, E., Naigino, R., Mukose, A., Makumbi, F., Esiru, G., Arinaitwe, J., Musinguzi, J., & Wanyenze, R. K. (2017). Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study. BMC Pregnancy and Childbirth, 17(1), 94. https://doi.org/10.1186/s12884-017-1276-x
Buregyeya E, et al. Facilitators and Barriers to Uptake and Adherence to Lifelong Antiretroviral Therapy Among HIV Infected Pregnant Women in Uganda: a Qualitative Study. BMC Pregnancy Childbirth. 2017 03 21;17(1):94. PubMed PMID: 28320347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study. AU - Buregyeya,Esther, AU - Naigino,Rose, AU - Mukose,Aggrey, AU - Makumbi,Fred, AU - Esiru,Godfrey, AU - Arinaitwe,Jim, AU - Musinguzi,Joshua, AU - Wanyenze,Rhoda K, Y1 - 2017/03/21/ PY - 2015/07/30/received PY - 2017/03/14/accepted PY - 2017/3/22/entrez PY - 2017/3/23/pubmed PY - 2017/12/28/medline SP - 94 EP - 94 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 17 IS - 1 N2 - BACKGROUND: In 2012, Uganda started implementing lifelong antiretroviral therapy (ART) for prevention of mother to child transmission (PMTCT) in line with the WHO 2012 guidelines. This study explored experiences of HIV infected pregnant and breastfeeding women regarding barriers and facilitators to uptake and adherence to lifelong ART. METHODS: This was a cross-sectional qualitative study conducted in three districts (Masaka, Mityana and Luwero) in Uganda, between February and May 2014. We conducted in-depth interviews with 57 pregnant and breastfeeding women receiving care in six health facilities, who had been on lifelong ART for at least 6 months. Data analysis was done using a content thematic approach with Atlas-ti software. RESULTS: Initiation of lifelong ART was done the same day the mother tested HIV positive. Several women felt the counselling was inadequate and had reservations about taking ART for life. The main motivation to initiate and adhere to ART was the desire to have an HIV-free baby. Adherence was a challenge, ranging from not taking the drugs at the right time, to completely missing doses and clinic appointments. Support from their male partners and peer family support groups enhanced good adherence. Fear to disclose HIV status to partners, drug related factors (side effects and the big size of the tablet), and HIV stigma were major barriers to ART initiation and adherence. Transition from antenatal care to HIV chronic care clinics was a challenge due to fear of stigma and discrimination. CONCLUSIONS: In order to maximize the benefits of lifelong ART, adequate preparation of women before ART initiation and on-going support through family support groups and male partner engagement are critical, particularly after birth and cessation of breastfeeding. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/28320347/Facilitators_and_barriers_to_uptake_and_adherence_to_lifelong_antiretroviral_therapy_among_HIV_infected_pregnant_women_in_Uganda:_a_qualitative_study_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1276-x DB - PRIME DP - Unbound Medicine ER -