title: Pattern and determinants of antiretroviral drug adherence among Nigerian pregnant women.
abstract: BACKGROUND
  The need for a high level of adherence to antiretroviral drugs has remained a major hurdle to achieving maximal benefit from its use in pregnancy. This study was designed to determine the level of adherence and identify factors that influence adherence during pregnancy.
  
  
  METHODS
  This is a cross-sectional study utilizing a semistructured questionnaire. Bivariate and multiple logistic regression models were used to determine factors independently associated with good drug adherence during pregnancy.
  
  
  RESULTS
  137 (80.6%) of the interviewed 170 women achieved adherence level of ≥ 95% using 3 day recall. The desire to protect the unborn child was the greatest motivation (51.8%) for good adherence. Fear of being identified as HIV positive (63.6%) was the most common reason for nonadherence. Marital status, disclosure of HIV status, good knowledge of ART, and having a treatment supporter were found to be significantly associated with good adherence at bivariate analysis. However, after controlling for confounders, only HIV status disclosure and having a treatment partner retained their association with good adherence.
  
  
  CONCLUSIONS
  Disclosure of HIV status and having treatment support are associated with good adherence. Maternal desire to protect the child was the greatest motivator for adherence.
authors.affiliation: Clinical Sciences Division, Nigerian Institute of Medical Research, P.M.B 2013, Yaba, Lagos, Nigeria. sozichu@yahoo.com
authors.forename: S O
authors.initials: SO
authors.lastname: Ekama
authors.forename: E C
authors.initials: EC
authors.lastname: Herbertson
authors.forename: E J
authors.initials: EJ
authors.lastname: Addeh
authors.forename: C V
authors.initials: CV
authors.lastname: Gab-Okafor
authors.forename: D I
authors.initials: DI
authors.lastname: Onwujekwe
authors.forename: F
authors.initials: F
authors.lastname: Tayo
authors.forename: O C
authors.initials: OC
authors.lastname: Ezechi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D030881:Disclosure; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D055118:Medication Adherence / Q000523:psychology; D015999:Multivariate Analysis; D009549:Nigeria; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents