The Retention in Antiretroviral Therapy and Its Associated Factors among Pregnant Women

Abstract

Background: Despite several interventions and efforts to reduce the rate of transmission of HIV infection to newborns, it has been observed that there are growing cases of HIV occurrence in Nigeria especially in the northern part of the country. One of the identified causes is the failure of HIV-positive pregnant women to continue their life-long ART therapy. Therefore, this study investigates the factors responsible for pregnant women opting out of their ART procedures. Methods: This is a quantitative study based on the analysis of secondary data from the medical records of 235 pregnant women who were enrolled in the HIV program between 2015 and 2019 in Gamboru Maternal and Child Health Clinic, Maiduguri, Nigeria. The characteristics of the patients and the prevalence of the factors and the retention rate were presented using frequencies and percentages. The predicting factors influencing ART retention were investigated using multiple logistic regression. Results: The age of the participants ranged between 15 and 45 years. The average age of the sample was 28.9 ± 5.74. The retention rate of the patients was low (40%). In the final logistic model, the study found phone ownership (aOR, 0.075, 95% CI 0.071 – 0.336, p=0.001) as the significant factor for retention. The model explained 9.2% of the variability in retention. Conclusion: This study highlights the critical issue of low retention in antiretroviral therapy (ART) among HIV-positive pregnant women in Maiduguri, Nigeria, with a retention rate of only 40%. Despite ongoing interventions to prevent mother-to-child transmission (PMTCT) of HIV, challenges persist, particularly regarding the continuous adherence to ART during pregnancy. One of the most significant findings from this research is the association between phone ownership and improved ART retention, suggesting that access to communication tools may play a pivotal role in ensuring adherence to therapy. The study emphasizes the importance of implementing focused strategies to overcome barriers to ART retention. Prioritizing the use of technology and improving access to communication tools, such as ensuring that pregnant women enrolled in ART programs have access to mobile phones, is crucial. Additionally, incorporating mobile health solutions, offering reminder systems, and promoting peer support through digital platforms could significantly improve adherence. To achieve sustained ART retention and prevent HIV transmission to newborns, it is essential to adopt a multifaceted approach that addresses socioeconomic, educational, and systemic barriers. Future research should explore additional predictive factors and evaluate the effectiveness of tailored interventions aimed at improving retention rates in resource-constrained settings. By addressing these gaps, it will be possible to advance Nigeria's progress in combating HIV/AIDS and safeguarding maternal and child health.