Social determinants of art adherence among adolescent and young pregnant and postpartum women living with HIV in Cape Town, South Africa
Women living with HIV in South Africa are at risk of poor antiretroviral therapy (ART) adherence during and after pregnancy. Adolescents have lower adherence rates than other age groups and experience several barriers to adherence. Pregnancy and postpartum periods also present unique obstacles. We assessed the association between social determinants of health and ART adherence (using a three-item self-report adherence scale and reported missed ART doses) among 100 pregnant and postpartum women aged 16-24 years and on ART in Gugulethu, Cape Town. Overall, 72% of women scored ≤95% on the adherence scale (69% and 75% among pregnant and postpartum women, respectively p=0.533) and 22% of women reported missing ≥1 day of ART in the past 30 days (31% and 15% among pregnant and postpartum women, respectively p=0.050). An adherence score ≤95% versus >95% was associated with lower employment (32% versus 50%, p=0.093) and slightly lower social connectedness scores (mean 4.71 versus 4.97, p=0.084). No demographic or social characteristics were statistically significantly associated with adherence in multivariable models. These findings highlight nuances to measuring self-reported ART adherence. Larger studies are needed to further explore adherence challenges and the role of social connection and adherence among young pregnant and postpartum women living with HIV in South Africa.
Networked Digital Library of Theses and Dissertations
Department of Public Health and Family Medicine