Adherence to option B+ and its association with disclosure status and counseling among HIV-positive pregnant and lactating women in Ethiopia: systematic review and meta-analysis

Public Health. 2022 Oct:211:105-113. doi: 10.1016/j.puhe.2022.07.016. Epub 2022 Sep 1.

Abstract

Objectives: This systematic review and meta-analysis aimed to assess the pooled estimate of option B+ level of adherence and its association with disclosure status and counseling among pregnant and lactation women in Ethiopia after option B+ implementation.

Study design: Systematic review and meta-analysis.

Methods: We searched Web of Science, MEDLINE, PUBMED, Scopus, Embase, CINAHL, and Google Scholar databases for studies reporting adherence to option B+ and its association with disclosure status and counseling among pregnant and lactating women in Ethiopia. Heterogeneity was assessed by forest plot, Cochran's Q test, and I2 test. A random effects model was calculated to estimate the pooled prevalence of adherence toward option B+.

Results: We included eight studies, which gives a total of 1852 pregnant and lactating women in this systematic review and meta-analysis. The overall pooled estimate of good adherence toward option B+ antiretroviral therapy (ART) drug among pregnant and lactating women in Ethiopia was 84.23% (95% confidence interval [CI]: 80.79-87.66). Women who have disclosed their HIV status to their partner (adjusted odds ratio = 4.48, 95% CI: 1.86-10.76) and got counseling during the antenatal period (adjusted odds ratio = 5.02, 95% CI: 2.43-10.34) had a positive association with good adherence to option B+ ART drugs.

Conclusion: Four of five pregnant and lactating women have good adherence to option B+ ART drugs in Ethiopia. Therefore, promoting HIV disclosure status to partners and enhancing counseling services should be strengthened to improve adherence toward option B+ among pregnant and lactating women.

Keywords: Adherence; Ethiopia; Meta-analysis; Option B+; Systematic review; Women.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Counseling
  • Disclosure
  • Ethiopia / epidemiology
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Seropositivity* / epidemiology
  • Humans
  • Lactation
  • Pregnancy
  • Pregnant Women / psychology
  • Prevalence