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Objectives: The aim of this study was to identify the determinants of non-adherence to antiretroviral therapy among pregnant women in the district of Manhiça, Mozambique.

Methods: In this preliminary analysis we used de-identified, aggregate data collected within a large parent study. Data included age groups, marital status, education, occupation, religion, and residence. For select pregnant women, a more detailed in-depth interview was conducted to explore the association of the socio-demographic factors on consumption of ART medications.

Non-adherence was determined through pill counts and self-reports, and defined as taking less than 95% of the prescribed ART doses for each of the first two months since initiating prenatal care visits.

Results: Preliminary analysis of the 127 participants recruited into this study, based on pill count, only 33% of our population was adherent to ART during each of the two months period following initiation of their prenatal care. In multivariable models of analysis, the characteristics most significantly associated with being non-adherent to one´s ART were decreased age (OR=0.90; 95% CI=0.90-1.03), being a widow (OR=3.0; 95% CI=0.63-14.28) and initiating ART during the current pregnancy (OR=1.24; 95% CI=0.54-2.84).

Conclusions: Based on a more strict definition of adherence we found non-adherence to ART after only two months in the Option B+ program was far inferior to national reports which estimate adherence based on measurements of retention. It is very likely that greater attention needs to be given to actual pill consumption and clinical measurements such as viral load to better monitor the adherence to ART and retention in care rather than just simply maintaining clinic visits and medication pick-up.

Key words: Adherence, HIV, Option B+, PMTCT, Mozambique