A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa

R. R. Cook, K. Peltzer, Stephen M Weiss, V. J. Rodriguez, Deborah Jones

Research output: Contribution to journalArticle

Abstract

While efforts to prevent mother-to-child transmission of HIV been successful in some districts in South Africa, rates remain unacceptably high in others. This study utilized Bayesian logistic regression to examine maternal-level predictors of adherence to infant nevirapine prophylaxis, including intimate partner violence, maternal adherence, HIV serostatus disclosure reaction, recency of HIV diagnosis, and depression. Women (N = 303) were assessed during pregnancy and 6 weeks postpartum. Maternal adherence to antiretroviral therapy during pregnancy predicted an 80% reduction in the odds of infant nonadherence [OR 0.20, 95% posterior credible interval (.11, .38)], and maternal prenatal depression predicted an increase [OR 1.04, 95% PCI (1.01, 1.08)]. Results suggest that in rural South Africa, failure to provide medication to infants may arise from shared risk factors with maternal nonadherence. Intervening to increase maternal adherence and reduce depression may improve adherence to infant prophylaxis and ultimately reduce vertical transmission rates.

LanguageEnglish (US)
Pages1-9
Number of pages9
JournalAIDS and Behavior
DOIs
StateAccepted/In press - Jan 4 2018

Fingerprint

Bayes Theorem
South Africa
Mothers
HIV
Depression
Nevirapine
Pregnancy
Disclosure
Postpartum Period
Logistic Models

Keywords

  • Adherence
  • HIV
  • Infants
  • South Africa
  • Women

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa. / Cook, R. R.; Peltzer, K.; Weiss, Stephen M; Rodriguez, V. J.; Jones, Deborah.

In: AIDS and Behavior, 04.01.2018, p. 1-9.

Research output: Contribution to journalArticle

@article{50414d9d27f64119b56d0c8a6e583aea,
title = "A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa",
abstract = "While efforts to prevent mother-to-child transmission of HIV been successful in some districts in South Africa, rates remain unacceptably high in others. This study utilized Bayesian logistic regression to examine maternal-level predictors of adherence to infant nevirapine prophylaxis, including intimate partner violence, maternal adherence, HIV serostatus disclosure reaction, recency of HIV diagnosis, and depression. Women (N = 303) were assessed during pregnancy and 6 weeks postpartum. Maternal adherence to antiretroviral therapy during pregnancy predicted an 80{\%} reduction in the odds of infant nonadherence [OR 0.20, 95{\%} posterior credible interval (.11, .38)], and maternal prenatal depression predicted an increase [OR 1.04, 95{\%} PCI (1.01, 1.08)]. Results suggest that in rural South Africa, failure to provide medication to infants may arise from shared risk factors with maternal nonadherence. Intervening to increase maternal adherence and reduce depression may improve adherence to infant prophylaxis and ultimately reduce vertical transmission rates.",
keywords = "Adherence, HIV, Infants, South Africa, Women",
author = "Cook, {R. R.} and K. Peltzer and Weiss, {Stephen M} and Rodriguez, {V. J.} and Deborah Jones",
year = "2018",
month = "1",
day = "4",
doi = "10.1007/s10461-017-2010-4",
language = "English (US)",
pages = "1--9",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",

}

TY - JOUR

T1 - A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa

AU - Cook, R. R.

AU - Peltzer, K.

AU - Weiss, Stephen M

AU - Rodriguez, V. J.

AU - Jones, Deborah

PY - 2018/1/4

Y1 - 2018/1/4

N2 - While efforts to prevent mother-to-child transmission of HIV been successful in some districts in South Africa, rates remain unacceptably high in others. This study utilized Bayesian logistic regression to examine maternal-level predictors of adherence to infant nevirapine prophylaxis, including intimate partner violence, maternal adherence, HIV serostatus disclosure reaction, recency of HIV diagnosis, and depression. Women (N = 303) were assessed during pregnancy and 6 weeks postpartum. Maternal adherence to antiretroviral therapy during pregnancy predicted an 80% reduction in the odds of infant nonadherence [OR 0.20, 95% posterior credible interval (.11, .38)], and maternal prenatal depression predicted an increase [OR 1.04, 95% PCI (1.01, 1.08)]. Results suggest that in rural South Africa, failure to provide medication to infants may arise from shared risk factors with maternal nonadherence. Intervening to increase maternal adherence and reduce depression may improve adherence to infant prophylaxis and ultimately reduce vertical transmission rates.

AB - While efforts to prevent mother-to-child transmission of HIV been successful in some districts in South Africa, rates remain unacceptably high in others. This study utilized Bayesian logistic regression to examine maternal-level predictors of adherence to infant nevirapine prophylaxis, including intimate partner violence, maternal adherence, HIV serostatus disclosure reaction, recency of HIV diagnosis, and depression. Women (N = 303) were assessed during pregnancy and 6 weeks postpartum. Maternal adherence to antiretroviral therapy during pregnancy predicted an 80% reduction in the odds of infant nonadherence [OR 0.20, 95% posterior credible interval (.11, .38)], and maternal prenatal depression predicted an increase [OR 1.04, 95% PCI (1.01, 1.08)]. Results suggest that in rural South Africa, failure to provide medication to infants may arise from shared risk factors with maternal nonadherence. Intervening to increase maternal adherence and reduce depression may improve adherence to infant prophylaxis and ultimately reduce vertical transmission rates.

KW - Adherence

KW - HIV

KW - Infants

KW - South Africa

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=85040033348&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040033348&partnerID=8YFLogxK

U2 - 10.1007/s10461-017-2010-4

DO - 10.1007/s10461-017-2010-4

M3 - Article

SP - 1

EP - 9

JO - AIDS and Behavior

T2 - AIDS and Behavior

JF - AIDS and Behavior

SN - 1090-7165

ER -