Abstract

Adherence to the prevention of mother-to-child transmission of HIV in developing countries faces several barriers. The aim of the study is to identify factors determining adherence to follow-up care in the prevention of mother-to-child transmission among pregnant women living with HIV in Cross River State, Nigeria. It is a cross-sectional study applying systematic sampling techniques among antenatal attendees living with HIV. A well-structured questionnaire was administered. The respondents who registered for Antenatal care (ANC) in the three selected health facilities between January 2017 and December 2018 were followed up for the first six months post-delivery due to feasibility and possible loss to follow-up. Follow-up data were collected from the facility database from the date of registration in ANC till delivery for adherence and non-adherence. Data were analyzed using SPSS version 25.0. At a 95% confidence interval, a p-value of <0.05 was considered statistically significant. A total of 199 participants, with a mean age of 31.09 ± 6.04 years, mostly aged 26 to 35 years (114, 57.3%), residing in urban areas (136, 68.3%), married (140, 79.4%), and having secondary education (116, 58.3%). The prevalence of adherence to PMTCT follow-up was 131 (65.8%). No significant association was observed between adherence and age, place of residence, and marital status (p > 0.05). The self-employed (2.84, 1.40-5.80) adhere to follow-up care more than the unemployed (p < 0.05). Women who did not face stigma and rejection (1.18, 0.62 - 2.24) adhere more than those who face rejection and stigmatization. The findings from this study are eye-openers to the real reasons why some clients in South-South Nigeria may not fully participate in the PMTCT program. All stakeholders should design sustainable interventions that will improve ART adherence to enhance the elimination of mother-to-child transmission of HIV.

Key words: Prevention of mother-to-child transmission, HIV, pregnancy, women.