{
  "abstract": "Background Treatment adherence is vital in tackling public health issues. HIV remains a public health challenge, affecting over 39 million people worldwide, and about 2 million in Nigeria. The global HIV-care goal is for 95% of HIV-infected individuals to know their status, access treatment/adherence, and achieve viral suppression. Nigeria has not yet met these targets, as most HIV-infected people on treatment have not achieved viral suppression. This study investigates HIV-treatment adherence in pregnancy/during breastfeeding, associated factors, barriers, facilitators, and perspectives on improving adherence.Methods A mixed-methods study with 2,008 HIV-infected pregnant/breastfeeding women for the quantitative component and 48 participants for the qualitative component across six geopolitical zones in Nigeria. Quantitative data were collected from medication-refill records and self-reports, and qualitative data through semi-structured interviews. Adherence was optimal if HIV-infected pregnant/breastfeeding women took ≥95% of treatment doses in the last 30days and suboptimal if <95%. Statistical and thematic analyses were conducted for the quantitative and qualitative components, respectively.Results 79.33% participants were breastfeeding, and 20.67% pregnant. HIV treatment adherence was 100% for medication-refills; 97.67% for self-report, with very similar rates for pregnancy and breastfeeding. Women with optimal adherence were over 1,400 times more likely to achieve viral suppression (OR:1466.54, 95% CI:397-5,405, p=0.001). Participants identified adherence-counselling/treatment knowledge, free HIV-treatment, phone-call follow-ups/home-visits, positive healthcare-providers’ behaviour, alarm-setting, disclosure, partner/family support, desire for HIV-free children as facilitators. Barriers were forgetfulness, treatment burden, non-disclosure, fear of stigma/discrimination, being busy.Conclusion HIV treatment adherence level in this study was optimal and higher than the rates reported elsewhere, despite some participants reporting specific barriers. Optimal adherence was associated with viral suppression. Continuous adherence counselling, free HIV-treatment availability, disclosure, social support, and other identified facilitators could help to improve/sustain optimal adherence. Investigating adherence and viral suppression in more States among women of reproductive age is necessary.",
  "authors": [
    {
      "affiliations": [
        "Population Health Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK"
      ],
      "name": "Celestine Effiong"
    }
  ],
  "title": "P08-1 HIV treatment adherence in pregnancy and during breastfeeding",
  "uid": "30ea7bc7-f1f5-5763-a8db-27913763e32c"
}