Acceptability of option B+ among HIV positive women receiving antenatal and postnatal care services in selected health centre's in Lusaka

BMC Pregnancy Childbirth. 2018 Dec 29;18(1):510. doi: 10.1186/s12884-018-2142-1.

Abstract

Background: In 2013, Zambia accepted the immediate operationalization of Option B+, a policy used to try and eliminate mother to child transmission. This policy requires all HIV-positive pregnant and breastfeeding women to initiate antiretroviral treatment for life regardless of CD4 count. However, not all HIV positive women accept treatment for life. This study aimed to investigate acceptability of lifelong ART (Option B+) among HIV positive women receiving antenatal and postnatal services at the university teaching hospital and Lusaka urban city clinics.

Methods: This was a cross sectional study conducted in November, 2016 to March 2017. The study population comprised of HIV positive women in their reproductive age (15-49 years). A Structured questionnaire was used to collect data in a face to face interview with the participants. Data was entered in EpiData version 3.1 and analysed using Stata version 13. Multivariate logistic regression analysis was performed to determine predictors of acceptability.

Results: Overall, 427 women participated in this study. Their mean age was 30 years. Of the 427, over half (54%) had inadequate knowledge and about 30% of the women in the study still experience stigma and discrimination.63.2% of the women had good attitude towards Option B+ and overall, the majority (77.8%) were willing to accept antiretroviral therapy for life. Multivariate analysis showed that only women with good attitude were 9.4 times more likely to accept Option B+ than those with a bad attitude [OR: 9.4: 95%CI, 5.8-15.2)].

Conclusion: This study showed that in general, women accepted initiation of Option B+. However, there is still a gap in the level of knowledge of Option B+ as well as stigma and discrimination in some communities, hence there is need to intensify programs that are aimed at educating the community on the importance of ART for life, combat stigma and discrimination and consequently promote acceptability of Option B+.

Keywords: Acceptability; Antiretroviral therapy; Attitude; Discrimination; Option B +; Prevention of mother to child transmission; knowledge.

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Breast Feeding
  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • Female
  • HIV Seropositivity / drug therapy*
  • HIV Seropositivity / immunology
  • HIV Seropositivity / transmission*
  • Health Knowledge, Attitudes, Practice*
  • Health Policy
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pregnancy
  • Social Discrimination
  • Social Stigma
  • Surveys and Questionnaires
  • Young Adult
  • Zambia

Substances

  • Anti-HIV Agents