Online Program

Antiretroviral Adherence Behavior among Reproductive Age Malawian Women

Tuesday, November 3, 2015 : 2:30 p.m. - 2:43 p.m.

Ogbochi McKinney, DrPH, MPH, MPA, Health Science, California Baptist University, Riverside, CA
Naomi Modeste, DrPH, Health Promotion and Education, Loma Linda University School of Public Health, Loma Linda, CA
Jerry W. Lee, PhD, Health Promotion and Education, Loma Linda University School of Public Health, Loma Linda, CA
Daniel Pearce, DO, FACOI, AAHIVS, School of Medicine, Loma Linda University, Loma Linda, CA
Adamson Muula, PhD, Department of Community Health, University of Malawi, College of Medicine, Blantyre, Malawi
Ron Mataya, MD, School of Public Health, Loma Linda University, Loma Linda, CA
Background.  Although HIV treatment is readily available in Malawi, adherence is a major public health concern.  The Theory of Planned Behavior’s (TPB’s) proximal variables (intention and perceived behavioral control) are considered to predict behavior.  However, when TPB was used to measure HIV medication adherence in South Africa, intention did not predict behavior.  We tested the TPB in 2 Malawi HIV clinics. Methods.  From October to December 2013, we administered interview-guided TPB and adherence questionnaires to 358 women at two Antiretroviral Therapy (ART) clinics in Southern Malawi.  Logistic regression analyses were used to assess associations to adherence.  Results.  Intention was not a significant predictor of self-reported adherence while perceived behavioral control (OR=.49), location (OR=.28), food insecurity (OR=.60), and patients’ attitude (OR=2.66) were significant predictors of adherence.  Interactions were found between attitude, side effects, and food insecurity.  However, attitude predicted better adherence only when food insecurity (OR=9.84; p=.001; CI=2.67, 36.23) or side effects (OR=3.45; p=.03; CI=1.10, 10.8) were high.  Conclusion.  Program planners and implementers who wish to predict women’s ART adherence in order to develop effective adherence interventions may want to consider the following predictors: perceived behavioral control, location, food insecurity, and especially patients’ attitude.  To maximize adherence, these items must be addressed adequately.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Assess factors associated with antiretroviral therapy of HIV positive Malawian women.

Keyword(s): Adherence, Treatment Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been fortunate to do some research work in Malawi and other developing countries, and as I have engaged with PLWHA, I learned alot about their journey in their community. The stories of discrimination and stigmatization, especially among marginalized groups such as women and children, broke my heart. Having learned more about the socio-economic burdens of women living with HIV/AIDS, I was motivated to look for ways to contribute to the fight against HIV/AIDS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4332.0: Women’s health