Barriers to utilization of anti-retroviral therapy among HIV positive pregnant women in Birnin Kebbi, North West Nigeria

Hongrui Jia, Christopher O. Solo, Amechi E. Igharo, Mamdouh A. Saleh Al-Faryan

Abstract

Mother-to-child transmission of HIV remains a significant public health concern, particularly in resource-limited societies. Antiretroviral therapy, which effectively reduces transmission risks and enhances maternal health, is central to global efforts to control HIV among pregnant women. However, uptake of this therapy continues to face various challenges. This study investigates barriers to the utilization of antiretroviral therapy among HIV-positive pregnant women in Birnin Kebbi, North West Nigeria. A cross-sectional study design was adopted, employing key informant and in-depth interviews involving 320 HIV-positive pregnant women accessing antenatal care. Findings show that key barriers include socio-demographic factors such as younger age, low educational attainment and poor socio-economic status. HIV-related stigma significantly discouraged disclosure and delayed healthcare-seeking behaviors. Misconceptions regarding the safety of antiretroviral therapy during pregnancy further deterred women from initiating and adhering to treatment. Inadequate healthcare infrastructure and geographical accessibility also hindered access to therapy services. This study concludes that interventions focusing on community education to reduce stigma, correcting misconceptions about therapy safety, improving healthcare infrastructure, and integrating antiretroviral therapy into antenatal care could substantially increase utilization, reduce transmission, and improve maternal and child health outcomes in Nigeria.

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Musa A, Mamman B, Mala AK, Abba U, Abdullahi MK and

Abdullahi IS. Determinants of Knowledge, Attitude

and Practice Towards Prevention of Mother to Child

Transmission of HIV/AIDS Among Pregnant

Women Attending Antenatal Clinic at Urban

Maternity Bauchi, Bauchi State, Nigeria. Science.

;9(4):23-31.

Danlami MB, Muhammad A, Aliyu B, Yahaya TO,

Muhammad ZK, Manga SB. HIV screening among

prospective blood donors who are negative for

conventional screening methods in referral hospitals

in Kebbi State Nigeria. Microbes Infect Dis.

;4(3):792-9.

Ayodapo AO. Prevalence of psychiatric comorbidities

among adult out-patients living with HIV/AIDS in a

tertiary care center, North-Central Nigeria: a cross

sectional study. Middle East Curr Psychiatry.

;31(1):71.

Audu RA. Detection of High-Risk Human Papillomavirus

Genotypes Among HIV-Infected Women in Four

States in Nigeria. Cureus. 2024;16(3).

Okwuraiwe AP, Ogbonne EL, Adeniyi AO, Ihurhe PI, Musa

BO and Abe TR. Detection of High-Risk Human

Papillomavirus Genotypes Among HIV-Infected

Women in Four States in Nigeria. Cureus.

;16(3).

Semo BW, Ezeokafor NA, Oyawola B, Mugo C. Effect of

Multi-Month Dispensing on Viral Suppression for

Newly Enrolled Adolescents and Adults in Northern

Nigeria. HIV/AIDS Res Palliat Care. 2023:697-704.

Idowu S, Badru OA, Idowu A, Ajayi A, Idowu O.

Determinants of Family Support Among People

Living with HIV Seeking Care in a Tertiary Hospital

in Lagos State, Nigeria: A Cross-Sectional Study.

Fam Soc. 2024;10443894231216306.

Abbani AY, Usman MG. Factors Associated with Men's

Fertility Intentions and Family Planning Practice in

Kebbi State, North-western Nigeria. Ife Soc Sci Rev.

;31(1):67-82.

Badru OA, Bain LE, Adeagbo OA. Does adherence to

antiretroviral therapy differ by place of residence in

Nigeria? A systematic review and meta-analysis

protocol. BMJ Open. 2023;13(7):e070024.

Ibraheem AS, Odeigah LO, Kuranga IS, Amoko A, Nwosu

CB and Omowumi RK. Prevalence of psychiatric

comorbidities among adult out-patients living with

HIV/AIDS in a tertiary care center, North-Central

Nigeria: a cross-sectional study. Middle East Curr

Psychiatry. 2024;31(1):71.

Okeke C, Ezenwaka U, Ekenna A, Onyedinma C,

Onwujekwe O. Analysing the progress in service

delivery towards achieving universal health coverage

in Nigeria: a scoping review. BMC Health Serv Res.

;23(1):1094.

Tukur UM, Isah BA. Reported ADRs of efavirenz-based

antiretroviral drugs among outpatients attending

sexually transmitted infections clinic in a tertiary

health facility in Northern Nigeria. Natl J Pharmacol

Ther. 2023;1(3):133-6.

Lawal TV, Oyedele OK, Andrew NP. On characterizing

gender and locational composition of adult PLHIV in

Nigeria: Implications for HIV programming. PLOS

Glob Public Health. 2024;4(8):e0002863.

Mugo C, Adedokun O, Alo OD, Ezeokafor N, Adeyemi S,

Kpamor Z, et al. Effects of the COVID-19 pandemic

on HIV service delivery and viral suppression:

Findings from the SHARP program in Northern

Nigeria. PLoS One. 2024;19(4):e0300335.

Okonko IO, Shaibu N, Okonko BJ, Ogbuji CC, Frank

Peterside N. HIV/malaria co-infection and its

determinants among people living with HIV/AIDS in

Yenagoa, Bayelsa state, Nigeria. Magna Sci Adv

Biol Pharm. 2023;9(01):020-38.

Alyafei, A., & Easton-Carr, R. (2024). The health belief

model of behavior change. In StatPearls [Internet].

StatPearls

Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK606120/

Onovo AA, Adeyemi A, Onime D, Kalnoky M, Kagniniwa

B and Dessie M. Estimation of HIV prevalence and

burden in Nigeria: a Bayesian predictive modelling

study.

EClinicalMedicine.

;62.

https://doi.org/10.1016/j.eclinm.2023.102098

Nabity-Grover T, Cheung CM, Thatcher JB. How COVID

stole Christmas: How the pandemic shifted the

calculus around social media Self-Disclosures. J Bus

Res.

;

:

https://doi.org/10.1016/j.jbusres.2022.113310

Xu, Y., Peng, M. Y. P., Ahuru, R. R., Anser, M. K.,

Osabohien, R., & Aziz, A. (2022). Individual and

community-level factors associated with non

institutional delivery of women of childbearing-age

in

Nigeria. Humanities and Social Sciences

Communications, 9(1),

-7.

https://doi.org/10.1057/s41599-022-01168-7

I

Feng Y, Ahuru RR, Anser MK, Osabohien R, Ahmad M,

Efegber

AH.

Household economic wealth

management and antenatal care utilization among

business women in the reproductive-age. African

Journal of Reproductive Health. 2021; 25(6):143-54.

Sui Y, Ahuru RR, Huang K, Anser MK, Osabohien R.

Household socioeconomic status and antenatal care

utilization among women in the reproductive-age.

Frontiers in public health. 2022; 9:724337.

https://doi.org/10.3389/fpubh.2021.724337

Nasir MH, Anser MK, Ahuru RR, Osabohien R, Ebiaku KC,

Abbas S. A comparative study of the effect of health

insurance on women’s use of health facility delivery:

Evidence from demographic health survey in Benin

Republic. African Journal of Reproductive Health.

;26(6):104-15.

Azuh DE, Osabohien R, Orbih M, Godwin A. Public health

expenditure and under-five mortality in Nigeria: An

overview for policy intervention. Open Access

Macedonian Journal of Medical Sciences.

;8(E):353-62.

Jakovljevic M, Liu Y, Cerda A, Simonyan M, Correia T,

Mariita RM, Kumara AS, Garcia L, Krstic K,

Osabohien R, Toan TK. The Global South political

economy of health financing and spending

landscape–history and presence. Journal of medical

economics.

;24(sup1)

https://doi.org/10.1080/13696998.2021.2007691

Zhang X, Anser MK, Ahuru RR, Zhang Z, Peng MY,

Osabohien R, Mirza M. Do predictors of health

facility delivery among reproductive-age women

differ by health insurance enrolment? A multi-level

analysis of Nigeria's data. Frontiers in Public Health.

,

:797272.

https://doi.org/10.3389/fpubh.2022.797272

Centers for Disease Control and Prevention (CDC). (2022).

Operation Triple Zero: Supporting Adolescents with

HIV to Achieve Better Health Outcomes. Retrieved

from

https://www.cdc.gov/global

health/impact/operation-triple-zero.html

ICAP at Columbia University. (2021). ICAP’s Operation

Triple Zero Program Provides Tailored Care to

Adolescents Living with HIV in Ethiopia. Retrieved

from https://icap.columbia.edu/news-events/icaps

operation-triple-zero-program-provides-tailored

care-to-adolescents-living-with-hiv-in-ethiopia

Zhou D, Ahuru RR, Yan M, Osabohien R, Jakovljevic M.

Influences of women empowerment indices on

demand for childcare services: Evidence from the

Nigeria Demographic and Health Surveys. African

Journal of Reproductive Health. 2023, 27(10):65-80.

Makanjuola, O. B., Fadeyibi, I. O., Olaniyan, O. (2019).

Barriers to Antiretroviral Therapy Adherence among

HIV Positive Pregnant Women in Nigeria: A

Qualitative Study. Journal of HIV/AIDS Social

Services, 18(3), 290-305.

Oladapo, O. T., Adetokunboh, O. Okunowo, A. (2020).

Factors Influencing Antiretroviral Therapy Uptake

among Pregnant Women Living with HIV in Nigeria:A Systematic Review. BMC Public Health, 20(1), 1

UNAIDS. (2020). Global AIDS Update: Seizing the

Moment - Tackling entrenched inequalities to end

epidemics. Geneva: UNAIDS.

World Health Organization (WHO). (2021). Consolidated

Guidelines on HIV Prevention, Diagnosis,

Treatment, and Care for Key Populations. Geneva:

WHO Press.

Hu S, Jiang S, Qi X, Bai R, Ye XY, Xie T. Races of small

molecule clinical trials for the treatment of COVID

: an up‐to‐date comprehensive review. Drug

Development Research. 2022; 83(1):16-54.

https://doi.org/10.1002/ddr.21895

Li S, Ling S, Wang D, Wang X, Hao F, Yin L, Yuan Z, Liu

L, Zhang L, Li Y, Chen Y. Modified lentiviral globin

gene therapy for pediatric β0/β0 transfusion

dependent β-thalassemia: A single-center, single

arm pilot trial. Cell Stem Cell. 2024;31(7):961-73.

https://doi.org/10.1016/j.stem.2024.04.021

Gao Y, Wang C, Wang K, He C, Hu K, Liang M. The

effects and molecular mechanism of heat stress on spermatogenesis and the mitigation measures.

Systems biology in reproductive medicine.

;68(5-6):331-47.

https://doi.org/10.1080/19396368.2022.2074325

Li XF, Zhang YJ, Yao YL, Chen MX, Wang LL, Wang MD,

Hu XY, Tang XJ, Zhong ZH, Fu LJ, Luo X. The

association of post–embryo transfer SARS-CoV-2

infection with early pregnancy outcomes in in vitro

fertilization: a prospective cohort study. American

Journal of Obstetrics and Gynecology.

;230(4):436-e1.

https://doi.org/10.1016/j.ajog.2023.12.022

Chen N, Pan J. The causal effect of delivery volume on

severe maternal morbidity: an instrumental variable

analysis in Sichuan, China. BMJ Global Health.

;7(5):e008428. https://doi.org/10.1136/bmjgh

-008428

Tian F, Pan J. Hospital bed supply and inequality as

determinants of maternal mortality in China between

and 2016. International journal for equity in

health. 2021:1-5.https://doi.org/10.1186/s12939

-01391-9

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