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

• Published in: PloS one 2021-02, Vol.16 (2), p.e0246467-e0246467
• Main Authors: Cordoba, Evette, Parcesepe, Angela M, Gallis, John A, Headley, Jennifer, Soffo, Claudian, Tchatchou, Berenger, Hembling, John, Baumgartner, Joy Noel
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Aggression; AIDS; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Bioinformatics; Biology and Life Sciences; Catholics; Child development; Childhood; Children; Clinical outcomes; Colleges & universities; Data analysis; Data collection; Development programs; Domestic violence; Drug therapy; Drug use; Editing; Epidemiology; Family violence; Global health; Happiness; Health aspects; Highly active antiretroviral therapy; HIV; HIV patients; Households; Human immunodeficiency virus; Hunger; Internet; Intimate partner violence; Maternal & child health; Medical screening; Medicine and Health Sciences; Mental depression; Mental disorders; Mental health; Mental health services; Nurses; Nursing; Patient compliance; Patient outcomes; People and Places; Population; Pregnancy; Pregnant women; Psychological aspects; Public health; Reviews; Scholarship; Social aspects; Social Sciences; Supervision; Women; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0246467

This 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. The 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. Almost 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]). Suboptimal 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.