Adherence to Antiretroviral Therapy and Associated Psychosocial Factors among Mothers Attending Antenatal Clinics in Selected Public Referral Hospitals in Nairobi County, Kenya

Abstract

Background: Adherence to antiretroviral therapy may be affected by various psychosocial factors but there is scant literature to support this in resource constrained settings. The study aimed at assessing the level of adherence to antiretroviral therapy and the associated psychosocial factors among mothers attending antenatal clinics at Mbagathi and Kenyatta National Hospitals. Methods: This was a descriptive cross-sectional study conducted between the months of April and July 2023 among 70 HIV infected mothers attending the antenatal clinics. Assessment on level of adherence to antiretroviral therapy was done using the well-established 8-scale Morisky Medication adherence tool. The associated psychosocial support was assessed using the documented Multidimensional Scale for Perceived Social Support tool. Data analysis was done using IBM Statistical Package for Social Sciences version 23. Statistical associations with P<0.05 were considered statistically significant. Results: The mean age of the study population was 32.3 (SD 5.78), had attained at least a secondary school education level (47.1%), married (75.7%) and participants’ average duration on antiretroviral therapy (ART) was 6 months. Adherence to antiretroviral therapy was at 78.8% among the mothers, with low, moderate and high adherence at 47.1%, 21.4% and 31.4% respectively. The levels of social support were low (47.1%), moderate (45.7%) and high social support (7.1%). There was a statistically significant association between level of education and adherence (aOR= 0.276, 95%CI: 0.075 – 1.019, P=0.05) but no statistically significant association between adherence and the level of psychosocial support. Conclusion: The level of adherence to antiretroviral therapy among the mothers was suboptimal but this was not associated with the level of psychosocial support accorded but with low academic achievements. Adherence mechanisms should therefore be intensified among mothers with low education level. Further studies to underscore other potential barriers to adherence such as side effects of antiretroviral therapy and socio-economic variables are recommended.