Factors contributing to non-utilization of Antretroviral(ARVs) drug for prevention of mother to child transmission by HIV positive-Pregnant women in Lusaka, Zambia

Abstract

Mother-to-Child Transmission (MTCT) is by far the largest source of HIV infection in children below the age of 15 years. Children who acquire the virus through Mother-to-Child Transmission do so before birth, during birth, or through breastfeeding. In the absence of any intervention, the transmission of the virus from Mother -To- Child is 40 percent. The study sought to determine factors contributing to non-utilization of antiretroviral (ARVs) drugs for Prevention of Mother - To - Child Transmission (PMTCT) among HIV positive pregnant women in Lusaka urban district. A comparative study design was used in six health centres in Lusaka, Zambia. A total of 320 HIV positive antenatal/postnatal mothers were randomly selected of which 160 utilized ARVs for PMTCT and 160 did not utilize ARVs for PMTCT. It was revealed from the study that the independent factors associated with non-utilization of ARVs for PMTCT were willingness to take an HIV test, reaction to HIV positive result, informing spouse, family members and friends, knowledge about the possibility of HIV transmission from the mother to the baby, and knowledge about the benefits of ARVs for PMTCT.The respondents who were willing to take an HIV test were 4.35 times more likely to utilize ARVs for PMTCT compared to those who were not willing to have HIV test O. R = 4.35 (95% CI, 2.22, 8.33). Respondents who denied the HIV positive result were 0.33 times less likely to utilize ARVs compared to those who accepted the results OR = 0.33 (95% CI 0.18, 0.58). Respondents who informed their spouses, family members and friends about their HIV status were 2.13 times more likely to utilize ARVs compared to those who did not inform their spouse, family members and friends about their HIV status OR 2.13 (95% CI 1.25, 3.70). In addition, the respondents who were more knowledgeable about the possibility of transmission of HIV from the mother to the baby were 6.25 times more likely to utilize ARVs compared to those who had less knowledge about the transmission of HIV from mother to baby OR = 6.25 (95% CI 2.22, 16.67) . The women who knew the benefits of ARVs for PMTCT were 5.26 times more likely to utilize ARVs compared to those who did not know the benefits of ARVs for PMTCT OR = 5.26 (95% CI 3.23, 8.33). In conclusion, integration of VCT into PMTCT activities, a positive attitude towards an HIV positive result, support from spouse, family members and friends, awareness that HIV can be transmitted from mother to baby and knowledge that ARVs can prevent the transmission of HIV from mother to baby would increase the uptake of ARVs for PMTCT.