A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa.
While efforts to prevent mother-to-child transmission of HIV been successful in some districts in South Africa, rates remain unacceptably high in others. This study utilized Bayesian logistic regression to examine maternal-level predictors of adherence to infant nevirapine prophylaxis, including intimate partner violence, maternal adherence, HIV serostatus disclosure reaction, recency of HIV diagnosis, and depression. Women (N = 303) were assessed during pregnancy and 6 weeks postpartum. Maternal adherence to antiretroviral therapy during pregnancy predicted an 80% reduction in the odds of infant nonadherence [OR 0.20, 95% posterior credible interval (.11, .38)], and maternal prenatal depression predicted an increase [OR 1.04, 95% PCI (1.01, 1.08)]. Results suggest that in rural South Africa, failure to provide medication to infants may arise from shared risk factors with maternal nonadherence. Intervening to increase maternal adherence and reduce depression may improve adherence to infant prophylaxis and ultimately reduce vertical transmission rates.
['Cook|R R|RR|http://orcid.org/0000-0001-8754-995X', 'Peltzer|K|K|', 'Weiss|S M|SM|', 'Rodriguez|V J|VJ|', 'Jones|D L|DL|']
D000293:Adolescent D000328:Adult D019380:Anti-HIV Agents D001499:Bayes Theorem D003863:Depression D019052:Depression, Postpartum D030881:Disclosure D005260:Female D015658:HIV Infections D006801:Humans D007223:Infant D007231:Infant, Newborn D018445:Infectious Disease Transmission, Vertical D000066511:Intimate Partner Violence D016015:Logistic Models D055118:Medication Adherence D019829:Nevirapine D056990:Post-Exposure Prophylaxis D011247:Pregnancy D011251:Pregnancy Complications, Infectious D012424:Rural Population D013019:South Africa D013997:Time Factors D055815:Young Adult
Infants HIV South Africa Adherence Women