Exploring the acceptability of option b plus among hiv-positive nigerian women engaged and not engaged in the prevention of mother-to-child transmission of hiv cascade: A qualitative study

Salome C. Erekaha, Llewellyn J. Cornelius, Melissa L. Bessaha, Abdulmumin Ibrahim, Gabriel D. Adeyemo, Mofoluwake Fadare, Manhattan Charurat, Echezona E. Ezeanolue, Nadia A. Sam-Agudu

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The acceptability of lifelong antiretroviral therapy (ART) among HIV-positive women in high-burden Nigeria, is not well-known. We explored readiness of users and providers of prevention of mother-to-child transmission of HIV (PMTCT) services to accept lifelong ART-before Option B plus was implemented in Nigeria. We conducted 142 key informant interviews among 100 PMTCT users (25 pregnant-newly-diagnosed, 26 pregnant-in-care, 28 lost-to-follow-up (LTFU) and 21 postpartum women living with HIV) and 42 PMTCT providers in rural North-Central Nigeria. Qualitative data were manually analyzed via Grounded Theory. PMTCT users had mixed views about lifelong ART, strongly influenced by motivation to prevent infant HIV and by presence or absence of maternal illness. Newly-diagnosed women were most enthusiastic about lifelong ART, however postpartum and LTFU women expressed conditionalities for acceptance and adherence, including minimal ART side effects and potentially serious maternal illness. Providers corroborated user findings, identifying the postpartum period as problematic for lifelong ART acceptability/adherence. Option B plus scale-up in Nigeria will require proactively addressing PMTCT user fears about ART side effects, and continuous education on long-term maternal and infant benefits. Structural barriers such as the availability of trained providers, long clinic wait times and patient access to ART should also be addressed.

Original languageEnglish (US)
Pages (from-to)128-137
Number of pages10
JournalSahara J
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by the National Institute of Health’s Fogarty International Centre, under award number D43TW01041 to the University of Maryland Baltimore-Institute of Human Virology’s AIDS International Training and Research Program in Nigeria and by the World Health Organization through an award for the INtegrating and Scaling up PMTCT through Implementation REsearch (INSPIRE) initiative from Global Affairs Canada.

Funding Information:
The authors would like to thank all the women living with HIV and providers at the PHCs who participated in this study. We also acknowledge all study staff who contributed to data collection and analysis. This study was supported by the National Institute of Health’s Fogarty International Centre, under award number D43TW01041 to the University of Maryland Baltimore-Institute of Human Virology’s AIDS International Training and Research Program in Nigeria and by the World Health Organization through an award for the INtegrating and Scaling up PMTCT through Implementation REsearch (INSPIRE) initiative from Global Affairs Canada.

Publisher Copyright:
© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Adherence
  • HIV
  • Nigeria
  • Option B plus
  • PMTCT
  • Rural

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