Attitudes Toward Long-Term Use of Antiretroviral Therapy Among HIV-Infected Pregnant Women in Moshi, Tanzania: A Longitudinal Study

Factors Affecting Antiretroviral Therapy Adherence among HIV-Positive Pregnant Women in Greece: An Exploratory Study

The human immunodeficiency virus (HIV) is a major public health problem globally. Each year, approximately 1.4 million women living with HIV get pregnant. This contemporary descriptive study investigates the degree of compliance of HIV-positive women-patients undergoing antiretroviral therapy (ART) during pregnancy. A sample of 200 treated HIV-positive pregnant women (mean age, 32.9 years; Greek nationality, 67.5%; poor educational level, 28.5%) was selected. The data collection occurred in three acquired immunodeficiency syndrome (AIDS) reference centers in Athens, Greece, from November 2019 to September 2021. Patients’ median knowledge score was 50% (IQR: 38.9−61.1%), and their median attitude score was 4.2 (IQR: 3.6−4.4); 13.0% of participants did comply with ART treatment. Specifically, 7.0% of them failed to take their treatment twice when asked about their activities over the preceding 7 days, and 3.0% skipped it three times. Women of Greek nationality had significantly higher compliance with treatment (p < 0.001). Additionally, a higher compared to lower education level was significantly associated with greater compliance (p = 0.001), while women with a low level of social support had significantly lower compliance. Participants who had complied with ART had significantly higher knowledge and attitude scores (p = 0.027). Patient characteristics determine compliance with ART in HIV-positive pregnant women in Greece, while the availability and quality of health system services may modulate this relationship.

The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania

HIV stigma has a profound impact on clinical outcomes and undermines the quality of life of people living with HIV (PLWH). Among HIV-negative individuals, misinformation and prejudicial attitudes about HIV can fuel stigma and contribute to discrimination against PLWH. Antenatal care (ANC), with its focus on universal HIV testing, provides a unique entry point to address HIV stigma. This study describes the development of a counseling intervention to address HIV stigma among women and their partners attending a first ANC appointment in Tanzania. Formative work to inform the intervention consisted of qualitative interviews with 32 pregnant and postpartum women (both women living with HIV and HIV-negative women) and 20 healthcare workers. Data were analyzed iteratively, using a thematic analysis approach, to identify intervention targets. The resulting intervention, Maisha (Swahili for "Life"), includes three sessions informed by the HIV Stigma Framework and Cognitive-Behavioral Therapy: a video and brief counseling session prior to HIV testing and, for those who test seropositive for HIV, two additional sessions building on the video content. A pilot test of the intervention is in process. Addressing HIV stigma at the first ANC visit can help individuals living with HIV to overcome stigma-related barriers to the initiation and maintenance of HIV care, and can reduce stigmatizing attitudes among those who test negative for HIV.