Frequency and factors associated with adherence to and completion of combination antiretroviral therapy for prevention of mother to child transmission in western Kenya

• DOI: 10.7448/ias.16.1.17994
• Publication Date: 2013-01-03T10:51:35Z
• Authors: Paul Ayuo; Beverly Musick; Hai Liu; Paula Braitstein; Winstone Nyandiko; Boaz Otieno‐Nyunya; Adrian Gardner; Kara Wools‐Kalous...
• Keywords: Cart; Disengagement theory; Regimen; Odds

Introduction The objective of this analysis was to identify points disruption within the prevention mother‐to‐child transmission (PMTCT) continuum from combination antiretroviral therapy (CART) initiation until delivery. Methods To address objective, electronic medical records all antiretroviral‐naïve adult pregnant women who were initiating CART for PMTCT between January 2006 and February 2009 Academic Model Providing Access Healthcare (AMPATH), western Kenya, reviewed. Outcomes interest clinician‐initiated change or stop in regimen, disengagement programme (any, early, late) self‐reported medication adherence. Disengagement categorized as early (any interval greater than 30 days visits but returning care prior delivery) late (no visit date delivery). association covariates outcomes assessed using bivariate (Kruskal‐Wallis test continuous variables Chi‐square categorical variables) multivariate logistic regression analysis. Results A total 4284 initiated 2009. majority (89%) reported taking their at every visit. There 18 (0.4%) deaths reported. Clinicians discontinued 10 patients (0.7%) while 1367 (31.9%) disengaged care. Of those disengaging, 404 (29.6%) 963 (70.4%) late. In model, odds decreased with increasing age (odds ratio [OR] 0.982; confidence [CI] 0.966–0.998) gestational (OR 0.925; CI 0.909–0.941). Women receiving a district hospital 0.794; 0.644–0.980) tuberculosis 0.457; 0.202–0.935) less likely disengage. higher married 1.277; 1.034–1.584). 0.902; 0.881–0.924). 0.936; 0.917–0.956). While they increased CD4 counts CART‐initiation 1.001; 1.000–1001) 1.297; 1.000–1.695) Conclusions embedded an treatment active outreach department, (67.4%) remained engaged received uninterrupted prenatal CART.