Examining the relationship between interpersonal support and retention in HIV care among HIV+ nursing mothers in Uganda

Abstract

Objective The global burden of HIV on women and pediatric populations are severe in sub-Saharan Africa. Global child HIV infection rates have declined, but this rate remains quite high in sub-Saharan Africa due to Mother-to-child transmission (MTCT). To prevent MTCT of HIV, postpartum women living with HIV (WLHIV) are required to return to a health facility for HIV care within 60 days after childbirth (Retention in HIV care). Studies suggest that interpersonal support was positively associated with retention in HIV care. However, information on this association is lacking among postpartum WLHIV in Uganda. Therefore, this study investigates the relationship between interpersonal support, measured with the Interpersonal Support Evaluation List (ISEL-12), and retention in HIV care. Results In a total of 155 postpartum WLHIV, 84% were retained in HIV care. ISEL-12 was negatively associated with retention in HIV care. Postpartum WLHIV retained in care (24.984 ± 4.549) have lower ISEL-12 scores compared to the non-retained group (27.520 ± 4.224), t(35.572) = − 2.714, p = 0.01. In the non-income earning sample, respondents retained in care (24.110 ± 4.974) have lower ISEL scores compared to the non-retained group (27.000 ± 4.855), t(20.504) = -2.019, p = 0.049. This was not significant among income earning WLHIV.

Influence of depression and interpersonal support on adherence to antiretroviral therapy among people living with HIV

“…Given these documented benefits, an intervention to strengthen interpersonal support could help improve ART adherence outcomes among PLHW, especially those in urban areas, concurrent with findings of previous interpersonal support interventions [ 25 , 45 ]. However, this finding is contrary to the results of a recent study in the Greater Accra Region of Ghana and Uganda, which showed interpersonal support from family and friends had no association with adherence [ 21 , 46 ].…”

“…Additionally, PLWH should remain in care for a lifetime, regardless of CD4 count or viral load [ 13 , 14 ]. Many PLWH in low-resourced countries do not take full advantage of ART services because of individual factors (e.g., depression, internalized stigma, poor attitudes and beliefs, forgetting to take ART, ART side effects, financial difficulty) [ 7 , 15 − 18 ], community factors (e.g., family and community norms or lack of social support) [ 19 – 21 ], and healthcare factors (e.g. inaccessibility of services) [ 22 , 23 ].…”

The association of HIV-related stigma and psychosocial factors and HIV treatment outcomes among people living with HIV in the Volta region of Ghana: A mixed-methods study

“…Importantly, fear of experiencing stigma is found to be a major factor preventing PLWH from disclosing their serostatus to partners and family members. This is consistent with other studies which found that PLWH who disclose their HIV status experience stigma from their family compared to those who do not disclose their status [ 37 , 41 – 43 ]. This highlights the importance of designing multilevel stigma reduction interventions that not only focus on PLWH but also on their family, partners, and community.…”

“…Consistent with prior studies [ 31 – 33 ], results in our study also indicate that none of those who had low internalized stigma reported depression symptoms, while those with high stigma reported more depressive symptoms, suggesting that stigma is associated positively with depression. Previous studies have reported associations between HIV-related stigma and negative health outcomes specifically [ 34 – 37 ]. Participants in our study also described how stigma impacted their mental health and engagement in care.…”

The role of social support in antiretroviral therapy uptake and retention among pregnant and postpartum women living with HIV in the Greater Accra region of Ghana

“…Theoretical assumptions suggest a positive relationship, indicating that increased social support should enhance adherence rates. However, existing research has yielded conflicting findings, with some studies supporting this assumption [ 13 , 14 ], while others have reported negative associations [ 15 , 16 ] or no significant relationship at all [ 11 ]. These inconsistencies necessitate a deeper investigation into the complex interplay between social support and ART adherence, especially in a different social group of HIV patients.…”