PLoS ONE (Jan 2021)

The syndemic effects of mental ill health, household hunger, and intimate partner violence on adherence to antiretroviral therapy among pregnant women living with HIV in Yaoundé, Cameroon.

  • Evette Cordoba,
  • Angela M Parcesepe,
  • John A Gallis,
  • Jennifer Headley,
  • Claudian Soffo,
  • Berenger Tchatchou,
  • John Hembling,
  • Joy Noel Baumgartner

DOI
https://doi.org/10.1371/journal.pone.0246467
Journal volume & issue
Vol. 16, no. 2
p. e0246467

Abstract

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BackgroundThis research advances understanding of interrelationships among three barriers to adherence to antiretroviral therapy (ART) among pregnant women living with HIV (WLWH) in Cameroon: probable common mental disorders (CMD), intimate partner violence (IPV), and hunger.MethodsThe sample included 220 pregnant WLWH in Cameroon. Multivariable modified Poisson regression was conducted to assess the relationship between IPV, hunger, and CMD on ART adherence.ResultsAlmost half (44%) of participants recently missed/mistimed an ART dose. Probable CMD was associated with greater risk of missed/mistimed ART dose (aRR 1.5 [95% CI 1.1, 1.9]). Hunger was associated with greater risk of missed/mistimed ART dose among those who reported IPV (aRR 1.9 [95% CI 1.2, 2.8]), but not among those who did not (aRR 0.8 [95% CI 0.2, 2.3]).ConclusionSuboptimal ART adherence, CMD, and IPV were common among pregnant WLWH in Cameroon. Pregnant WLWH experiencing IPV and hunger may be especially vulnerable to suboptimal ART adherence.