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Pontiki G, Sarantaki A, Nikolaidis P, Lykeridou A. Factors Affecting Antiretroviral Therapy Adherence among HIV-Positive Pregnant Women in Greece: An Exploratory Study. Healthcare (Basel) 2022; 10:healthcare10040654. [PMID: 35455832 PMCID: PMC9028468 DOI: 10.3390/healthcare10040654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
The human immunodeficiency virus (HIV) is a major public health problem globally. Each year, approximately 1.4 million women living with HIV get pregnant. This contemporary descriptive study investigates the degree of compliance of HIV-positive women-patients undergoing antiretroviral therapy (ART) during pregnancy. A sample of 200 treated HIV-positive pregnant women (mean age, 32.9 years; Greek nationality, 67.5%; poor educational level, 28.5%) was selected. The data collection occurred in three acquired immunodeficiency syndrome (AIDS) reference centers in Athens, Greece, from November 2019 to September 2021. Patients’ median knowledge score was 50% (IQR: 38.9−61.1%), and their median attitude score was 4.2 (IQR: 3.6−4.4); 13.0% of participants did comply with ART treatment. Specifically, 7.0% of them failed to take their treatment twice when asked about their activities over the preceding 7 days, and 3.0% skipped it three times. Women of Greek nationality had significantly higher compliance with treatment (p < 0.001). Additionally, a higher compared to lower education level was significantly associated with greater compliance (p = 0.001), while women with a low level of social support had significantly lower compliance. Participants who had complied with ART had significantly higher knowledge and attitude scores (p = 0.027). Patient characteristics determine compliance with ART in HIV-positive pregnant women in Greece, while the availability and quality of health system services may modulate this relationship.
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Affiliation(s)
| | - Antigoni Sarantaki
- Department of Midwifery, Faculty of Health & Care Sciences, University of West Attica, Egaleo, 122 43 Athens, Greece; (P.N.); (A.L.)
- Correspondence: ; Tel.: +30-2105387403
| | - Petros Nikolaidis
- Department of Midwifery, Faculty of Health & Care Sciences, University of West Attica, Egaleo, 122 43 Athens, Greece; (P.N.); (A.L.)
| | - Aikaterini Lykeridou
- Department of Midwifery, Faculty of Health & Care Sciences, University of West Attica, Egaleo, 122 43 Athens, Greece; (P.N.); (A.L.)
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Watt MH, Knettel BA, Knippler ET, Kisigo G, Ngocho JS, Renju J, Rogathi J, Sao SS, Minja L, Osaki H, Mwamba RN, Mmbaga BT. The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania. EVALUATION AND PROGRAM PLANNING 2020; 83:101859. [PMID: 32795711 PMCID: PMC7686260 DOI: 10.1016/j.evalprogplan.2020.101859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/10/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
HIV stigma has a profound impact on clinical outcomes and undermines the quality of life of people living with HIV (PLWH). Among HIV-negative individuals, misinformation and prejudicial attitudes about HIV can fuel stigma and contribute to discrimination against PLWH. Antenatal care (ANC), with its focus on universal HIV testing, provides a unique entry point to address HIV stigma. This study describes the development of a counseling intervention to address HIV stigma among women and their partners attending a first ANC appointment in Tanzania. Formative work to inform the intervention consisted of qualitative interviews with 32 pregnant and postpartum women (both women living with HIV and HIV-negative women) and 20 healthcare workers. Data were analyzed iteratively, using a thematic analysis approach, to identify intervention targets. The resulting intervention, Maisha (Swahili for "Life"), includes three sessions informed by the HIV Stigma Framework and Cognitive-Behavioral Therapy: a video and brief counseling session prior to HIV testing and, for those who test seropositive for HIV, two additional sessions building on the video content. A pilot test of the intervention is in process. Addressing HIV stigma at the first ANC visit can help individuals living with HIV to overcome stigma-related barriers to the initiation and maintenance of HIV care, and can reduce stigmatizing attitudes among those who test negative for HIV.
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Affiliation(s)
- Melissa H Watt
- Duke Global Health Institute, Duke University, Durham, NC, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | | | - Elizabeth T Knippler
- Duke Global Health Institute, Duke University, Durham, NC, USA; Gilling School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Godfrey Kisigo
- Duke Global Health Institute, Duke University, Durham, NC, USA; Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
| | - James S Ngocho
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
| | - Jenny Renju
- Kilimanjaro Christian Medical University College, Moshi, Tanzania; London School of Hygiene and Tropical Medicine, London, UK.
| | - Jane Rogathi
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
| | - Saumya S Sao
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Linda Minja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
| | - Haika Osaki
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
| | - Rimel N Mwamba
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Blandina T Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC, USA; Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
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