A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa |
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| Authors: | R R Cook K Peltzer S M Weiss V J Rodriguez D L Jones |
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| Institution: | 1.Department of Psychiatry and Behavioral Sciences,University of Miami Miller School of Medicine,Miami,USA;2.Department of Epidemiology, Fielding School of Public Health,University of California,Los Angeles,USA;3.HIV/AIDS/STIs and TB (HAST) Research Programme,Human Sciences Research Council,Pretoria,South Africa;4.ASEAN Institute for Health Development,Mahidol University,Salaya,Thailand;5.Department of Research & Innovation,University of Limpopo,Sovenga,South Africa |
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| Abstract: | 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. |
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