Self-efficacy and knowledge of Anti-Retroviral Therapy among a cohort of HIV-positive pregnant women in Option B+ from central Mozambique

Abstract

Objective: We assessed patient readiness for medication usage through knowledge of ART concepts and self-efficacy among pregnant HIV-infected patients in antenatal care as part of the Option B+ program in central Mozambique. Methods: Data were collected via in-person interviews conducted by facility nurses during enrollment visits in antenatal care. Study participants were categorized based on timing of first HIV diagnosis (prior to attending antenatal care, at antenatal care prior to study enrolment, or at antenatal care the day of study enrolment). Associations were described between timing of HIV diagnosis and socioeconomic characteristics, clinical characteristics, knowledge of ART concepts, and self-efficacy, accounting for facility level clustering. Knowledge and self-efficacy were categorized as high/low based on responses to questionnaires. Design: A cross-sectional analysis was carried out using baseline data from a cohort of HIV-infected pregnant women attending antenatal care at 10 public sector health facilities in Sofala Province, Mozambique. Results: Of 1,573 patients enrolled, 738 (47%) were first diagnosed with HIV upon study entry during their current pregnancy, 504 (32%) prior to study enrollment during their current pregnancy, and 331 (21%) prior to their current pregnancy. Women who were first diagnosed prior to enrollment, whether during current pregnancy (OR 0.31, 95% CI 0.21, 1.01) or prior to current pregnancy (0.22, 95% CI 0.13, 0.35) were less likely to have low ART knowledge. Additionally, those first diagnosed prior to enrollment, both during (OR 0.64, 95% CI 0.36, 1.12), and before their current pregnancy (OR 0.49, 95% CI 0.24, 0.97), were less likely to have low self-efficacy compared with those diagnosed on the day of study entry. Conclusions: We found that among study participants, women who were enrolled on the day of first HIV diagnosis and ART initiation were more likely to have low knowledge of ART concepts and low self-efficacy than women with a previous HIV diagnosis. These findings may provide an opportunity to identify women at high risk for loss to follow up and or low treatment adherence to achieve the recommended lifelong ART care under the Option B+ delivery model.