Maternal and infant antiretroviral therapy adherence among women living with HIV in rural South Africa: a cluster randomised trial of the role of male partner participation on adherence and PMTCT uptake

Figures & data

Table 1. Sample at baseline and bivariate associations with attrition (N = 1399).

	Total (N = 1399)	Lost (n = 877)	Retained (n = 522)	t/X^2, p
	N (%)	N (%)	N (%)
	Mean (SD)	Mean (SD)	Mean (SD)
Sociodemographics
Mean age in years (SD)	28.45 (5.82)	28.19 (5.71)	28.90 (5.98)	2.21, 0.027
Education
0–Grade 9	287 (20.5%)	175 (20.0%)	112 (21.5%)
Grade 10–11	673 (48.1%)	432 (49.3%)	241 (46.2%)
Grade 12 or more	439 (31.4%)	270 (30.8%)	169 (32.4%)	1.27, 0.529
Relationship status
Unmarried, living separate	754 (53.9%)	484 (55.2%)	270 (51.7%)
Unmarried, cohabiting	368 (26.3%)	219 (25.0%)	149 (28.5%)
Married	277 (19.8%)	174 (19.8%)	103 (19.7%)	2.34, 0.314
Work
Unemployed	1072 (76.6%)	680 (77.5%)	392 (75.1%)
Employed	327 (23.4%)	197 (22.5%)	130 (24.9%)	1.09, 0.297
Monthly income
< 1000 Rand (USD$70)	498 (35.6%)	348 (39.7%)	150 (28.7%)
≥ 1000	901 (64.4%)	529 (60.3%)	372 (71.3%)	17.10, < 0.001
Health variables
Dagnosed with HIV during this pregnancy
No	620 (45.3%)	373 (43.4%)	247 (48.4%)
Yes	749 (54.7%)	486 (56.6%)	263 (51.6%)	3.24, 0.072
Pregnancy unplanned
No	682 (49.8%)	426 (49.6%)	256 (50.2%)
Yes	687 (50.2%)	433 (50.4%)	254 (49.8%)	0.05, 0.829
Number of children
None	298 (20.8%)	198 (22.6%)	100 (19.2%)
One or more	1101 (78.7%)	679 (77.4%)	422 (80.8%)	2.28, 0.131
Partner HIV positive
No/unknown	1020 (73.0%)	664 (75.7%)	356 (68.5%)
Yes	377 (27.0%)	213 (24.3%)	164 (31.5%)	8.71, 0.003
Has HIV positive child
No	1032 (93.8%)	647 (95.3%)	385 (91.4%)
Yes	68 (6.2%)	32 (4.7%)	36 (8.6%)	1.35, 0.245
Time since ART initiation (months)	15.25 (25.37)	13.30 (23.77)	18.52 (27.57)	4.10, < 0.001
Time since HIV diagnosis (months)	24.15 (35.94)	22.14 (34.82)	27.55 (37.54)	3.25, 0.001
Psychosocial variables
Male involvement	7.30 (3.19)	7.30 (3.22)	7.28 (3.14)	0.33, 0.745
Stigma	1.27 (1.27)	1.31 (1.34)	1.22 (1.14)	0.55, 0.552
Family planning knowledge	4.48 (1.31)	4.45 (1.34)	4.53 (1.25)	2.15, 0.032
Depression	11.73 (6.01)	12.18 (5.93)	10.98 (6.07)	3.65, < 0.001
Psychological Intimate Partner Violence	3.46 (6.02)	3.27 (5.99)	3.78 (6.07)	1.75, 0.080
Physical Intimate Partner Violence	1.26 (4.16)	1.23 (4.28)	1.31 (3.93)	0.43, 0.671
Alcohol (> 2 drinks in a day in the past month)
No	1171 (85.5%)	740 (86.0%)	431 (84.5%)
Yes	199 (14.5%)	120 (14.0%)	79 (15.5%)	0.61, 0.435
Disclosure of HIV status to Partner
No	539 (39.3%)	352 (40.9%)	187 (36.7%)
Yes	831 (60.7%)	508 (59.1%)	323 (63.3%)	2.44, 0.118
Adherence variables
Maternal DBS Adherence (32 weeks of pregnancy)
Nonadherence	136 (24.0%)	52 (20.0%)	84 (27.4%)
Adherence	431 (76.0%)	208 (80.0%)	223 (72.6%)	4.18, 0.041
Maternal ACTG 100% 4-day Adherence
Nonadherence	429 (31.3%)	267 (31.1%)	162 (31.8%)
Adherence	940 (68.7%)	592 (68.9%)	348 (68.2%)	0.07, 0.793
Infant 100% 4-day ACTG Adherence
Nonadherence	68 (8.7%)	40 (7.7%)	28 (10.7%)
Adherence	711 (91.3%)	477 (92.3%)	234 (89.3%)	1.90, 0.168
Infant 100% 7-day VAS Adherence
Nonadherence	89 (11.4%)	54 (10.4%)	35 (3.3%)
Adherence	690 (88.6%)	463 (89.6%)	227 (86.7%)	1.46, 0.227

Table 2. Intervention effects and on maternal dry blood spot (DBS) adherence at 32 weeks (N = 567).

	Maternal DBS Adherence
Variable	AOR [95% CI]
Fixed effects
Condition	0.580 [0.192, 1.749]
Phase	0.761 [0.481, 1.205]
Intervention × Phase	1.924 [0.715, 5.175]
Controls (at baseline)
Age	1.011 [0.98, 1.043]
Monthly income	1.260 [0.853, 1.860]
Partner HIV positive	1.724 [0.769, 3.867]
Time since ART initiation	0.990 [0.976, 1.005]
Time since HIV diagnosis	1.001 [0.992, 1.011]
Family planning knowledge	0.856 [0.741, 0.989]*
Depression	0.993 [0.967, 1.020]
Male involvement	0.993 [0.942, 1.047]
Random effects	B (SE)	95% CI
Intercept	−1.092	−3.298, 1.114
Adherence	0.013	−0.074, 0.101
Model fit
−2LL (Deviance)	1483.71
Numbers of parameters	13
AIC/BIC	1509.713/1578.145
ICC (without covariates)	0.041

Table 3. Predicting adherence longitudinally at baseline and 32 weeks of pregnancy, and 6 weeks, 6, and 12 months post-partum.

	Maternal 100% 4-day
ACTG Adherence
Variable	AOR [95% CI]
Fixed effects
Condition	0.588 [0.212, 1.627]
Phase	1.303 [0.841, 2.020]
Intervention ×Phase	0.853 [0.455, 1.598]
Controls (at baseline)
Age	0.976 [0.948, 1.004]
Monthly income	1.142 [0.825, 1.579]
Partner HIV positive	0.546 [0.331, 0.899]*
Time since ART initiation	0.997 [0.988, 1.005]
Time since HIV diagnosis	0.997 [0.992, 1.003]
Family planning knowledge	0.901 [0.811, 1.003]
Depression	0.925 [0.901, 0.949]***
Male involvement	1.041 [0.984, 1.100]
Random Effects^a	B (SE)	95% CI
Intercept (baseline)	−0.025 (0.038)	−0.099, 0.049
Adherence	0.002 (0.001)	0.001, 0.004
Model fit
−2LL (Deviance)	7307.778
Numbers of parameters	27
AIC/BIC	7372.109/7503.464
ICC (without covariates)	0.000

Table 4. Intervention and phase effects on infant VAS and ACTG adherence at 6 weeks.

	Infant 100% 4-day	Infant 100% 7-day
	ACTG Adherence	VAS Adherence
	AOR [95% CI]	AOR [95% CI]
Fixed effects
Condition	1.992 [0.460, 8.619]	1.459 [0.369, 5.778]
Phase	1.422 [0.678, 2.982]	3.045 [1.326, 6.991]**
Intervention × Phase	0.466 [0.191, 1.133]	0.397 [0.154, 1.023]
Controls (at baseline)
Age	0.980 [0.937, 1.024]	0.996 [0.946, 1.049]
Monthly income	1.104 [0.548, 2.225]	1.201 [0.665, 2.167]
Partner HIV positive	0.860 [0.386, 1.918]	0.507 [0.230, 1.119]
Time since ART initiation	1.006 [0.980, 1.032]	1.008 [0.994, 1.023]
Time since HIV diagnosis	1.013 [0.995, 1.032]	0.993 [0.984, 1.002]
Family planning knowledge	0.851 [0.687, 1.055]	0.980 [0.841, 1.142]
Depression	0.949 [0.905, 0.995]*	0.941 [0.907, 0.975]**
Male involvement	1.022 [0.935, 1.117]	0.952 [0.876, 1.034]
Random effects	B (SE)	95% CI	B (SE)	95% CI
Intercept	3.757 (1.219)	−6.146, −1.367	−3.356 (0.951)	−5.219, −1.493
Adherence	0.031 (0.091)	−0.148, 0.210	0.031 (0.064)	−0.094, 0.157
Model fit
−2LL (Deviance)	821.658	960.832
Numbers of parameters	13	13
AIC/BIC	847.658 / 916.091	986.832/1055.265
ICC (without covariates)	0.068	0.104