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Open Access 01-12-2024 | Human Immunodeficiency Virus | Research

Adherence to option B + antiretroviral therapy and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa: a systematic review and meta-analysis

Authors: Lucresse Corine Fassinou, Diane Songwa Nkeunang , Thérèse Delvaux, Nicolas Nagot, Fati Kirakoya-Samadoulougou

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

To assess the adherence to option B + antiretroviral therapy (ART) and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa (SSA).

Methods

We conducted a comprehensive search from 01^st January 2012 to 03^rd October 2022, across four databases: PubMed, Scopus, Proquest Central, and Index Medicus Africain, to identify studies focused on pregnant and/or breastfeeding women living with HIV and receiving option B+ ART in SSA. Studies reporting adherence data were included in the meta-analysis. Were excluded studies published before 01^st January 2012, grey literature, systematic reviews, and meta-analysis studies. Articles selection and data extraction were performed independently by two reviewers. We evaluated pooled adherence and pooled association between various factors and adherence using a random-effects model.

Results

Overall, 42 studies involving 15,158 participants across 15 countries contributed to the meta-analysis. The overall pooled adherence was 72.3% (95% CI: 68.2–76.1%). Having high education level (pooled odds ratio (OR): 2.25; 95% CI: 1.57–3.21), living in urban area (pooled OR: 1.75; 95% CI: 1.10–2.81), disclosing status to a family/partner (pooled OR: 1.74; 95% CI: 1.27–2.40), having a support system (pooled OR: 3.19; 95% CI: 1.89–5.36), receiving counseling (pooled OR: 3.97; 95% CI: 2.96–5.34), initiating ART at early clinical HIV stage (pooled OR: 2.22; 95% CI: 1.08–4.56), and having good knowledge on PMTCT/HIV (pooled OR: 2.71; 95% CI: 1.40–5.25) were factors significantly associated with adherence to option B + ART.

Conclusions

Despite the implementation of option B+ ART, the level of adherence among pregnant and breastfeeding women in SSA falls short of meeting the critical thresholds for viral load suppression as outlined in the 95-95-95 objectives set for 2025. These objectives are integral for achieving HIV elimination, and in turn, preventing HIV mother-to-child transmission. To bridge this gap, urgent tailored interventions based on individual and structural factors are essential to enhance adherence within these subgroups of women. This targeted approach is crucial in striving towards the HIV elimination target in SSA.

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Title: Adherence to option B + antiretroviral therapy and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa: a systematic review and meta-analysis
Authors: Lucresse Corine Fassinou
Diane Songwa Nkeunang
Thérèse Delvaux
Nicolas Nagot
Fati Kirakoya-Samadoulougou
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Human Immunodeficiency Virus
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-023-17004-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Adherence to option B + antiretroviral therapy and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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