Understanding ART Adherence: Exploring the structural and psychosocial determinants of antiretroviral therapy adherence among pregnant women in Mpumalanga Province, South Africa

The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers’ adherence to their antiretroviral therapy (ART) medication is one of the crucial factors to achieve this target. The aim of the thesis was to better understand adherence as well as non-adherence to ART medication among HIV positive pregnant women in Mpumalanga province, South Africa. The thesis presents data of 673 HIV positive pregnant women in four cross-sectional studies and one longitudinal, clinic-randomized, PMTCT controlled trial. Disclosing HIV status and positive male involvement was highly associated with adherence. Stigma and partner violence was associated with non-adherence. Mothers were adherent while pregnant but changed to non-adherent a year after birth possibly due to change in necessity-concerns