Association of Literacy-Related Factors to Antiretroviral Therapy Adherence among Sero-Positive Pregnant Women in Murang’a County Referral Hospital, Kenya
Kiama John Mwaniki *
University of Nairobi, School of Nursing Sciences, P. O. BOX 19676-00202, Nairobi Kenya.
Hannah Inyama
University of Nairobi, School of Nursing Sciences, P. O. BOX 19676-00202, Nairobi Kenya.
Joyce Jebet
University of Nairobi, School of Nursing Sciences, P. O. BOX 19676-00202, Nairobi Kenya.
*Author to whom correspondence should be addressed.
Abstract
Background: Adherence of more than 95% to Antiretroviral Therapy (ART) is highly regarded as a success in HIV treatment. Globally, there are various challenges associated with ART adherence among sero-positive pregnant women especially in sub-Saharan Africa. In Kenya, there is inadequate information on challenges of ART adherence among sero-positive pregnant women.
Aim: This study aimed to establish literacy-related factors affecting ART adherence among sero-positive pregnant women.
Methodology: The research design was analytical cross-sectional design with a current case review of ANC records. The research study utilized both quantitative and qualitative methods of data collection using interviewer administered questionnaire for the sero-positive pregnant women and in-depth interview for the key informants. The interviewer-administered questionnaire was used on sero-positive pregnant women while one-on-one in-depth interview using interview-guide was utilized to obtain detailed information from Maternal and Child Health (MCH) unit nurse in-charge and doctor in-charge. The data was recorded using an audio recorder and in written notes. A data sheet was incorporated in current case review of clients’ viral load results and information concerning drug refill report.
The sample size was 57 sero-positive pregnant women who were sampled using census method. Quantitative data cleaning, entry and analysis employed the Statistical Package for Social Sciences (SPSS) Program version 20 while Chi square test and multivariate logistic regression was used to determine the challenges. Significance level of 95% was used to determine the strength of the association between variables. Qualitative data was analyzed using NVIVO 8 software.
Results: The literacy levels’ influence on ART adherence among the sero-positive pregnant women was significant in aspects such as low education level (p=0.01), poor knowledge on condom use (p=0.004), selective disclosure (p=0.003), poor compliance to ART (p=0.002) and sense of full recovery (p=0.009).
Conclusion: There are literacy related challenges that greatly affect ART adherence. These include; poor knowledge of condom use, selective disclosure, inadequate knowledge on importance of ART adherence, alcoholism, fear of being seen by others, sense of full recovery and lack of support from relatives. Other non-literacy related factors that also found to affect ART adherence include; forgetfulness, depression and unclear instructions.
Keywords: Adherence, pill count, viral load, sero-positive pregnant women, antiretroviral therapy, mortality