Abstract

Adherence to Antiretroviral Therapy (ART) is central to a successful prevention of mother- to- child transmission of HIV (PMTCT) programme by ensuring optimal viral suppression. However, barriers to adherence exist and differ among populations. This cross-sectional study was carried out among 368 HIV-positive pregnant mothers attending the PMTCT clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria to determine the prevalence and demographic variables related to non- adherence to ART. The mean age and parity of the women were 30.4 ± 4.4 years and 2.5 ± 2.0 respectively. Majority (97.0%) were married and had achieved secondary education and above (86.9%). One hundred and sixty five (44.8%) had been on ART for more than 2 years while 37.0 % commenced ART in the index pregnancy. The non adherence rate was 21.7%. The common reasons for missing ARV drugs were forgetfulness (63.8%);  feeling healthy and hence no need to take ARV drugs (16.3%) and living very far from the hospital (15.0%). Increasing maternal age (X² = 13.6; P = 0.001), low educational level (X² = 39.36 P = 0.002), extremes of parity (X² = 11.3 P = 0.03), husband’s low educational level (X² = 13.8; P = 0.01), being in a sero-concordant relationship (X² = 6.2; P = 0.05) and non-disclosure of HIV serostatus (X² = 12.96; P = 0.003) were significantly associated with non adherence to ART.  Those women who had been on ART for up to 2 years and beyond (X² = 9.52; P = 0.001), and those in whom the diagnosis of HIV was made before pregnancy (X² = 5.21; P = 0.02) were more likely to be non-adherent to therapy. These factors are recommended to guide counseling and design of programmes aimed at reducing non-adherence to ART.

Key words: Non-adherence, anti retroviral therapy, PMTCT, Nnewi, Nigeria.