Level of adherence to option B+ program and associated factors among HIV-positive women in Ethiopia: A systematic review and meta-analysis

Author:

Ayele Alemu DeguORCID,Kassa Bekalu Getnet,Mihretie Gedefaye Nibret,Belay Habtamu Gebrehana,Sewyew Dagne Addisu,Semahegn Abenezer Melkie,Yehuala Enyew Dagnew,Tiruneh Gebrehiwot Ayalew,Tenaw Lebeza Alemu,Sendekie Abrham Debeb,Teffera Adanech Getie,Aychew Eden Workneh,Belachew Yismaw Yimam,Liyeh Tewachew Muche,Worke Mulugeta DileORCID

Abstract

Background Despite policy initiatives and strategic measures highly focused on preventing mother-to-child transmission through the implementation of the Option B+ program, adherence to the treatment is still challenging. The level of adherence and determinants of Option B+ program utilization reported by different studies were highly inconsistent in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the pooled prevalence of adherence to the Option B+ program and its predictors among HIV-positive women in Ethiopia. Methods PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were searched for published articles from March 2010 to March 2022. The pooled prevalence of adherence was estimated using a weighted DerSimonian-Laird random effect model. The I2 statistics was used to identify the degree of heterogeneity. Publication bias was also assessed using the funnel plot and Egger’s regression test. Results A total of 15 studies were included. The pooled estimate of the option B+ program among HIV-positive women in Ethiopia was 81.58% (95% CI: 77.33–85.84). Getting social and financial support (AOR = 3.73, 95% CI: 2.12, 6.58), disclosure of HIV status to partners (AOR = 2.05, 95% CI: 1.75, 2.41), time to reach a health facility (AOR = 0.33, 95% CI: 0.16, 0.67), receiving counseling on drug side effects (AOR = 4.09, 95% CI: 2.74, 6.11), experience of drug side effects (AOR = 0.17, 95% CI: 0.08, 0.36), and knowledge (AOR = 4.73, 95% CI: 2.62, 8.51) were significantly associated with adherence to the Option B+ program. Conclusion This meta-analysis showed that the level of adherence to the Option B+ program in Ethiopia is lower than the 95% level of adherence planned to be achieved in 2020. Social and financial support, disclosure of HIV status, time to reach the health facility, counseling, drug side effects, and knowledge of PMTCT were significantly associated with option B+ adherence. The findings of this meta-analysis highlight that governmental, non-governmental, and other stakeholders need to design an effective strategy to scale up the level of disclosing one’s own HIV status, access health facilities, improve knowledge of PMTCT, and counsel the potential side effects of Option B+ drugs, and advocate the program to reduce the multidimensional burden of HIV/AIDS. Trial registration Prospero registration: CRD42022320947. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320947.

Publisher

Public Library of Science (PLoS)

Reference77 articles.

1. HIV: mother-to-child transmission;J.A. Volmink;BMJ clinical evidence,2008

2. WHO, UNICEF, UNAIDS, UNFPA. HIV transmission through breastfeeding: a review of available evidence an update from 2001 to 2007. Access 25/11/2020.

3. Wolrd Health Organization. PMTCT Strategic Vision 2010–2015: Preventing Mother-to-Child Transmission of HIV to Reach the UNGASS and Millennium Development Goals: Moving Towards the Elimination of Paediatric HIV, December 2009 (2010).

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