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Ameyaw EK, Nutor JJ, Okiring J, Yeboah I, Agbadi P, Getahun M, Agbadi W, Thompson RGA. The role of social support in antiretroviral therapy uptake and retention among pregnant and postpartum women living with HIV in the Greater Accra region of Ghana. BMC Public Health 2024; 24:540. [PMID: 38383341 PMCID: PMC10882784 DOI: 10.1186/s12889-024-18004-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 02/06/2024] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION The role of social support in antiretroviral therapy (ART) uptake and retention among pregnant and postpartum women in Ghana's capital, Accra, has received limited attention in the literature. This cross-sectional study extends existing knowledge by investigating the role of social support in ART adherence and retention among pregnant and postpartum women in Accra. METHODS We implemented a cross-sectional study in eleven (11) public health facilities. Convenience sampling approach was used to recruit 180 participants, out of which 176 with completed data were included in the study. ART adherence in the three months preceding the survey (termed consistent uptake), and ART retention were the outcomes of interest. Initial analysis included descriptive statistics characterized by frequencies and percentages to describe the study population. In model building, we included all variables that had p-values of 0.2 or lesser in the bivariate analysis to minimize negative confounding. Overall, a two-sided p-value of < 0.05 was considered statistically significant. Data were analyzed using Stata version 14.1 (College Station, TX). RESULTS In the multivariate model, we realized a lower odds trend between social support score and consistent ART adherence, however, this was insignificant. Similarly, both the univariate and multivariate models showed that social support has no relationship with ART retention. Meanwhile, urban residents had a higher prevalence of ART adherence (adjusted Prevalence ratio (aPR) = 2.04, CI = 1.12-3.73) relative to rural/peri-urban residents. As compared to those below age 30, women aged 30-34 (aPR = 0.58, CI = 0.34-0.98) and above 35 (aPR = 0.48, CI = 0.31-0.72) had lower prevalence of ART adherence Women who knew their partner's HIV status had lower prevalence of ART adherence compared to those who did not know (aPR = 0.62, CI = 0.43-0.91). Also, having a rival or co-wife was significantly associated with ART retention such that higher prevalence of ART adherence among women with rivals relative to those without rivals (aOR = 1.98, CI = 1.16-3.36). CONCLUSION Our study showed that social support does not play any essential role in ART adherence among the surveyed pregnant and postpartum women. Meanwhile, factors such as having a rival and being under the age of thirty play an instrumental role. The study has signaled the need for ART retention scale-up interventions to have a multi-pronged approach in order to identify the multitude of underlying factors, beyond social support, that enhance/impede efforts to achieve higher uptake and retention rates.
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Affiliation(s)
- Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong, China
- Africa Interdisciplinary Research Institute, Accra, Ghana
- L & E Research Consult Ltd, Wa, Upper West Region, Ghana
| | - Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA.
| | - Jaffer Okiring
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Isaac Yeboah
- Africa Interdisciplinary Research Institute, Accra, Ghana
- Institute of Work Employment and Society, University of Professional Studies, Accra, Ghana
| | - Pascal Agbadi
- Africa Interdisciplinary Research Institute, Accra, Ghana
- Department of Sociology and Social Science Policy, Lingnan University, Hong Kong, China
| | - Monica Getahun
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Wisdom Agbadi
- Africa Interdisciplinary Research Institute, Accra, Ghana
- Push Aid Africa, Accra, Ghana
| | - Rachel G A Thompson
- Africa Interdisciplinary Research Institute, Accra, Ghana
- Language Center, College of Humanities, University of Ghana, Accra, Ghana
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Moore ED, Caiola C, Cary M, Humphreys J. A Qualitative Study of the Social Relationship Experiences Across the Life Course Among Black/African American Women Aging With HIV in the South. J Assoc Nurses AIDS Care 2024:00001782-990000000-00091. [PMID: 38261540 DOI: 10.1097/jnc.0000000000000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
ABSTRACT Black/African American women continue to be disproportionately affected by HIV, facing multiple intersecting challenges that influence how they age and effectively manage their health. Supportive social relationships have been shown to help mitigate challenges and improve health in women with HIV, but little is known about Black/African American women's perceptions of social relationships. Guided by Life Course Theory, in-depth life history interviews were conducted with 18 Black/African American women aged 50+ years. In older adulthood, most important relationships among Black/African American women were with their adult children and grandchildren, intimate partners, God, and friends from the community. Factors that influenced relationships over time included: (a) a desire to build a community; (b) a need to empower oneself and give back; (c) yearning to engage the younger generation; and (d) battling HIV stigma. Older Black/African American women with HIV played a critical role in the education of the younger generation.
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Affiliation(s)
- Elizabeth D Moore
- Elizabeth D. Moore, PhD, MSc, FNP-BC, ACRN, was a doctoral student in the School of Nursing, Duke University, Durham, North Carolina, at the time the research was completed. She is now an Instructor, Department of Medicine, at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Courtney Caiola, PhD, MPH, RN, CNE, is an Assistant Professor, Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
- Michael Cary, PhD, RN, FAAN is an Associate Professor in the School of Nursing, Duke University, Durham, North Carolina, USA
- Janice Humphreys, PhD, RN, FAAN, is a Professor Emerita in the School of Nursing, Duke University, Durham, North Carolina, USA
| | - Courtney Caiola
- Elizabeth D. Moore, PhD, MSc, FNP-BC, ACRN, was a doctoral student in the School of Nursing, Duke University, Durham, North Carolina, at the time the research was completed. She is now an Instructor, Department of Medicine, at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Courtney Caiola, PhD, MPH, RN, CNE, is an Assistant Professor, Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
- Michael Cary, PhD, RN, FAAN is an Associate Professor in the School of Nursing, Duke University, Durham, North Carolina, USA
- Janice Humphreys, PhD, RN, FAAN, is a Professor Emerita in the School of Nursing, Duke University, Durham, North Carolina, USA
| | - Michael Cary
- Elizabeth D. Moore, PhD, MSc, FNP-BC, ACRN, was a doctoral student in the School of Nursing, Duke University, Durham, North Carolina, at the time the research was completed. She is now an Instructor, Department of Medicine, at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Courtney Caiola, PhD, MPH, RN, CNE, is an Assistant Professor, Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
- Michael Cary, PhD, RN, FAAN is an Associate Professor in the School of Nursing, Duke University, Durham, North Carolina, USA
- Janice Humphreys, PhD, RN, FAAN, is a Professor Emerita in the School of Nursing, Duke University, Durham, North Carolina, USA
| | - Janice Humphreys
- Elizabeth D. Moore, PhD, MSc, FNP-BC, ACRN, was a doctoral student in the School of Nursing, Duke University, Durham, North Carolina, at the time the research was completed. She is now an Instructor, Department of Medicine, at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Courtney Caiola, PhD, MPH, RN, CNE, is an Assistant Professor, Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina, USA
- Michael Cary, PhD, RN, FAAN is an Associate Professor in the School of Nursing, Duke University, Durham, North Carolina, USA
- Janice Humphreys, PhD, RN, FAAN, is a Professor Emerita in the School of Nursing, Duke University, Durham, North Carolina, USA
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