Maternal adherence

assessment and correlates of

adherence to lifelong ART
(Option B+) in Nyanza Kenya

Introduction
Research question: to evaluate the
proportion of option B+ clients
adherent to ART and the correlates of
non adherence in 10 ICAP supported
facilities
Collaborators: NASCOP, NIH
implementation Science Alliance

Rationale
Lifelong ART for all HIV infected pregnant and
lactating women
Simplification of ART provision, reduced
maternal morbidity and mortality, increased
chances of preventing transmission of HIV
Benefits only possible with acceptable levels of
adherence to treatment
Option B+ rolled out in Kenya in June 2014
Little known about adherence to ART and
correlates of non adherence
Gap to be addressed by conducting a nested
analysis of data collected within the MIR4Health
Study
1. Progress Report on Global Plan towards Elimination. Geneva, September 2012. 2. UNAIDS, Getting to Zero. Joint United Nations Program on HIV/AIDS,
2010, Geneva , Switzerland 3. National AIDS and STI Control Program (NASCOP). Guidelines for prevention to mother to child transmission (PMTCT)
HIV/AIDS in Kenya. Third Edition 2009. http://nascop.or.ke/library/pmtct/PMTCT%20Guideline-March%202010.pdf Accessed on December 10th 2011 4.
Joint IATT Technical Review Mission Report. Prevention of mother-to-child transmission of HIV (PMTCT) and Pediatrics HIV/AIDS Care and Treatment.
Republic of Kenya, UNICEF. November 2010 5 National AIDS and STI Control Program ( NASCOP) Prevention of Mother-to-Child Transmission of
HIV(PMTCT) and Pediatric HIV/AIDS Care and Treatment. [Web Page]. NASCOP Website. http://nascop.or.ke/pmtct/Accessed on December 19th 2011 6.
Mother Infant Retention for Health (MIR4Health) study conducted in 10 ICAP supported sites

Goal/Objectives
Goal: to evaluate the proportion of
Option B+ clients adherent to ART care
and the correlates of non adherence in
10 sites
Objectives:
- Identify proportion of Option B+ clients
adherent to ART care
- Identify the correlates of non adherence
to ART amongst Option B+ clients

Data sources
Routinely collected aggregate data
Patient level data from the electronic
database and charts
Data from MOH registers

Methods/Design
Nested analysis within MIR4Health study
protocol where data will be abstracted
Areas of interest: maternal adherence
assessment, adherence self efficacy,
depression assessment, medication belief,
HIV knowledge, perceived availability of
support
Sites: Bondo, Ahero, Ambira, Siaya, Ukwala,
Nyakach, Madiany, Masogo, Got Agulu,
Jootrh

Sampling
Inclusion criteria: all patients that were
initiated on ART and who had a viral load at
6 months postpartum
Main outcomes: patient demographics,
health outcomes at 6months
Statistical methods for analysis: survival
analysis; linear regression proportion of
clients with viral suppression at 6months:
correlates of non adherence to ART at
6monthd post partum

Contd
IRB approval: KEMRI
Timeframe: 6 months