HIV-infected pregnant women have greater adherence with antiretroviral drugs than non-pregnant women

Vaz, Maria José Rodrigues; Barros, Sônia; Palácios, Ricardo; Senise, Jorge Figueiredo; Lunardi, L.; Amed, Abês Mahmed; Castelo, Adauto

doi:10.1258/095646207779949808

Cited by 48 publications

(48 citation statements)

References 9 publications

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“…Among women already using antiretroviral drugs, the most common combination was two nucleoside reverse transcriptase inhibitors (NRTI) and one protease inhibitor (PI) or one non-nucleoside reverse transcriptase inhibitor (NNRTI). Ninety percent of women (295 in 328) reported good adhesion (95% or more of all HAART had been taken as prescribed, in two occasions) to treatment during pregnancy [22]. …”

Section: Resultsmentioning

confidence: 99%

Mother-to-child transmission of human immunodeficiency virus in aten years period

et al. 2011

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Objectivesto evaluate mother-to-child transmission (MTCT) rates and related factors in HIV-infected pregnant women from a tertiary hospital between 2000 and 2009.Subjects and methodcohort of 452 HIV-infected pregnant women and their newborns. Data was collected from recorded files and undiagnosed children were enrolled for investigation. Statistical analysis: qui-square test, Fisher exact test, Student t test, Mann-Whitney test, ANOVA, risk ratio and confidence intervals.ResultsMTCT occurred in 3.74%. The study population displayed a mean age of 27 years; 86.5% were found to have acquired HIV through sexual contact; 55% were aware of the diagnosis prior to the pregnancy; 62% were not using HAART. Mean CD4 cell-count was 474 cells/ml and 70.3% had undetectable viral loads in the third trimester. HAART included nevirapine in 35% of cases and protease inhibitors in 55%; Zidovudine monotherapy was used in 7.3%. Mean gestational age at delivery was 37.2 weeks and in 92% by caesarian section; 97.2% received intravenous zidovudine. Use of AZT to newborn occurred in 100% of them. Factors identified as associated to MTCT were: low CD4 cell counts, elevated viral loads, maternal AIDS, shorter periods receiving HAART, other conditions (anemia, IUGR (intra uterine growth restriction), oligohydramnium), coinfecctions (CMV and toxoplasmosis) and the occurrence of labor. Use of HAART for longer periods, caesarian and oral zidovudine for the newborns were associated with a decreased risk. Poor adhesion to treatment was present in 13 of the 15 cases of transmission; in 7, coinfecctions were diagnosed (CMV and toxoplasmosis).ConclusionUse of HAART and caesarian delivery are protective factors for mother-to-child transmission of HIV. Maternal coinfecctions and other conditions were risk factors for MTCT.

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Section: Resultsmentioning

confidence: 99%

Mother-to-child transmission of human immunodeficiency virus in aten years period

et al. 2011

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“…Lower adherence in women may be due to multiple conditions more common in women. Reduced adherence was found to be associated with depression [13,48], lack of supportive interpersonal relationships [48,58], young age [64,69,71], and drug [57,67,71] and alcohol use [64,71]. Additionally, non-adherence in women specifically was associated with black ethnicity [64,67], non-pregnancy, ART of six or more pills per day [69], women with a higher number of children [67], selfperception of abdominal fat gain [64], sleep disturbances [13], and increased levels of distress [58].…”

Section: Discussionmentioning

confidence: 98%

Women and Vulnerability to HAART Non-Adherence: A Literature Review of Treatment Adherence by Gender from 2000 to 2011

et al. 2011

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A literature review of original research articles on adherence to antiretroviral therapy (ART) in developed countries, covering January 2000 to June 2011, was conducted to determine if gender differences exist in the prevalence of nonadherence to ART. Of the 1,255 articles reviewed, only 189 included data on the proportion of the study population that was adherent and only 57 (30.2%) of these reported proportional adherence values by gender. While comparing articles was challenging because of varied reporting strategies, women generally exhibit poorer adherence than men. Thirty of the 44 articles (68.2%) that reported comparative data on adherence by gender found women to be less adherent than men. Ten articles (17.5%) reported significant differences in proportional adherence by gender, nine of which showed women to be less adherent than men. These findings suggest that in multiple studies from developed countries, female gender often predicts lower adherence. The unique circumstances of HIV-positive women require specialized care to increase adherence to ART.

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“…Few other studies have compared pregnant and non-pregnant women, with most indicating lower adherence during pregnancy. [21,22]…”

Section: Discussionmentioning

confidence: 99%

Effect of Pregnancy and the Postpartum Period on Adherence to Antiretroviral Therapy Among HIV-Infected Women Established on Treatment

Henegar

Westreich

Maskew

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Among women who become pregnant after initiating highly active antiretroviral therapy (HAART), few data describe the effect of pregnancy and postpartum on adherence. We conducted a retrospective clinical cohort study among therapy-naive women (ages 18–45) initiating HAART in Johannesburg, South Africa. Among 7,510 women in our analysis, 896 experienced a pregnancy after starting HAART. Compared to non-pregnant periods of follow-up, there was an increased risk of non-adherence during the postpartum period (weighted risk ratio (RR): 1.46, 95% confidence interval (CI): 1.17, 1.82), but not during pregnancy itself (weighted RR: 0.95, 95% CI: 0.78, 1.17).

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HIV-infected pregnant women have greater adherence with antiretroviral drugs than non-pregnant women

Cited by 48 publications

References 9 publications

Mother-to-child transmission of human immunodeficiency virus in aten years period

Mother-to-child transmission of human immunodeficiency virus in aten years period

Women and Vulnerability to HAART Non-Adherence: A Literature Review of Treatment Adherence by Gender from 2000 to 2011

Effect of Pregnancy and the Postpartum Period on Adherence to Antiretroviral Therapy Among HIV-Infected Women Established on Treatment

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