Health Systems and Policy Research

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Adherence to Prevention of Mother-to-Child Transmission Service and its Effect on HIV Status of Children Born to HIV Mothers in Tema Metropolis

Andrews Asamoah* and Ruth Panford

Background: WHO has estimated that 15%-45% of infants exposed to HIV are likely to be infected vertically and this continues to remain a challenge for management of HIV in children even with the existence of HIV and AIDS Anti- Retroviral Treatment (ART). Prevention of Mother-to-Child Transmission (PMTCT) of HIV program was put in place by WHO to reduce mother-to-child transmission of HIV in children born to HIV positive pregnant women. Although there is an availability of PMTCT interventions, utilization of the services is limited in Sub Saharan Africa including Ghana and this has resulted in high infection rates among children. The study therefore seeks to assess the factors that influence adherence to PMTCT in an urban setting and its effect on early infant diagnosis PCR results.

Method: This study adopted a cross-sectional design with retrospective review of all existing folders of HIV positive pregnant women who registered with Tema General Hospital between 2012 and 2016. A total of 316 records of HIV pregnant women who utilize ART clinic were retrieved, however, 253 records of pregnant women were used for the study due to incomplete records of other pregnant women. Bivariate and multiple logistics regression analysis were conducted to test significant factors that influence adherence to PMTCT programmer. Linear regression analysis was conducted to determine factors that influence EID PCR results of children born to the HIV positive pregnant mothers.

Results: The mean age of the study participants is 30.4 and nearly half 124 (49.0%) had only JHS education. About three-fourth (73.9%) are self-employed while majority (79.1%) are married. The proportion of PMTCT nonadherence among HIV pregnant women was 198 (78.3%) while non-HIV serostatus disclosure was 52 (20.6%). The PCR result for children born to the HIV positive mothers showed a positivity rate of 3.6%. Adherence to PMTCT programme was significantly influenced by disclosure of HIV serostatus to sexual partners (AOR: 6.1; CI: 1.7-22.4) and adequate knowledge about HIV and PMTCT (AOR-7.4; 3.5-9.7). The PCR HIV positivity result of EID was significantly associated with adherence to PMTCT (p=0.004), disclosure of HIV status (p=0.015) and receiving prophylaxis at birth (p=0.000).

Conclusion: PMTCT adherence still remains a challenge among HIV pregnant women affecting the fundamentals of the mother-to-child prevention strategies. HIV and PMTCT education should be strengthened at ART clinics as well as integrating HIV education at focus antenatal care services.