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Adherence to option B + antiretroviral therapy and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa: a systematic review and meta-analysis.

Authors :
Fassinou, Lucresse Corine
Songwa Nkeunang, Diane
Delvaux, Thérèse
Nagot, Nicolas
Kirakoya-Samadoulougou, Fati
Source :
BMC Public Health; 1/5/2024, Vol. 24 Issue 1, p1-22, 22p
Publication Year :
2024

Abstract

Background: To assess the adherence to option B + antiretroviral therapy (ART) and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa (SSA). Methods: We conducted a comprehensive search from 01<superscript>st</superscript> January 2012 to 03<superscript>rd</superscript> October 2022, across four databases: PubMed, Scopus, Proquest Central, and Index Medicus Africain, to identify studies focused on pregnant and/or breastfeeding women living with HIV and receiving option B+ ART in SSA. Studies reporting adherence data were included in the meta-analysis. Were excluded studies published before 01<superscript>st</superscript> January 2012, grey literature, systematic reviews, and meta-analysis studies. Articles selection and data extraction were performed independently by two reviewers. We evaluated pooled adherence and pooled association between various factors and adherence using a random-effects model. Results: Overall, 42 studies involving 15,158 participants across 15 countries contributed to the meta-analysis. The overall pooled adherence was 72.3% (95% CI: 68.2–76.1%). Having high education level (pooled odds ratio (OR): 2.25; 95% CI: 1.57–3.21), living in urban area (pooled OR: 1.75; 95% CI: 1.10–2.81), disclosing status to a family/partner (pooled OR: 1.74; 95% CI: 1.27–2.40), having a support system (pooled OR: 3.19; 95% CI: 1.89–5.36), receiving counseling (pooled OR: 3.97; 95% CI: 2.96–5.34), initiating ART at early clinical HIV stage (pooled OR: 2.22; 95% CI: 1.08–4.56), and having good knowledge on PMTCT/HIV (pooled OR: 2.71; 95% CI: 1.40–5.25) were factors significantly associated with adherence to option B + ART. Conclusions: Despite the implementation of option B+ ART, the level of adherence among pregnant and breastfeeding women in SSA falls short of meeting the critical thresholds for viral load suppression as outlined in the 95-95-95 objectives set for 2025. These objectives are integral for achieving HIV elimination, and in turn, preventing HIV mother-to-child transmission. To bridge this gap, urgent tailored interventions based on individual and structural factors are essential to enhance adherence within these subgroups of women. This targeted approach is crucial in striving towards the HIV elimination target in SSA. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14712458
Volume :
24
Issue :
1
Database :
Complementary Index
Journal :
BMC Public Health
Publication Type :
Academic Journal
Accession number :
174638714
Full Text :
https://doi.org/10.1186/s12889-023-17004-9