Factors influencing the use of anti-retroviral drugs in the prevention of mother -to-child transmission of HIV in Nairobi, Kenya

Abstract

Women represent 43% of all adults living with HIV/AIDS. The majority of these (80%) are of childbearing age. This has raised a lot of concern about perinatal transmission of HIV. Mother-to-child transmission of HIV can occur during antenatal period (10-20%), labour period and delivery (35-50%) and breastfeeding (40-50%). Anti-retroviral drugs are one element in prevention of mother-to-child transmission of HIV that is of great importance. Although ant-retroviral drugs have become common in developing countries and have been in use for over a decade, there are no systemic surveys to find out the factors that influence their usage in many countries including Kenya. Across sectional descriptive study was carried out in Nairobi at Mbagathi District Hospital, Marie Stopes (Eastleigh Nursing Home) and Pumwani Maternity hospital to determine the factors that influence the use of antiretroviral drugs in prevention of mother-to-child transmission of HIV. A total of 110 HIV positive pregnant women attending antenatal clinics at the health care facilities were included in the study. Data was collecetd using structured questionnaires, interview guides and check lists. Data was analyzed using the scientific package for social sciences (SPSS) software. Chi-square test was perfomed to establish the relationship between variables. The results indicate that the level of knowledge among HIV positive pregnant women on ARV was good (76%) and there was a significant statistical relationship between those who had heard of ARVs and education level of the respondents (=26.99; df=3; = 0.000). Majority of the respondents (86.4%) were not using ARVs and there was a significant statistical relationship between those who were on ARVs and education level ( = 12.91; df=3; and employment type (= 12.564; df=2; The reasons for non-usage of ARV were cost of drugs (79.1%) and inaccessibility (42.8%). There was a significant relationship between those who could purchase the drugs and employment type ( = 39.69; df=2; In this study, antiretroviral therapy was mainly targeting the labour period due to lack of essential drugs to target the antenatal period. The results of the study suggest that there is need for health education for HIV-positive pregnant women to encourage ART in an effort to prevent mother-to-child transmission of HIV. Anti-retroviral drugs should be made accessible and affordable to HIV-positive pregnant women. VCT should be advocated among pregnant women so that they can know their serostatus early to start therapy. The findings of this study will be of use to HCP so that they can intensify education campaigns on ART and also to drug companies in providing affordable drugs particularly to resource-strained countries.