HIV is undoubtedly a pressing issue of womens health as women represent 47% of new HIV cases1. Antiretroviral therapy (ART) has altered HIV contamination to a manageable chronic health problem, on the contrary, the possibility of transmission to the unborn child is 15–45% via gestation, childbirth, or breastfeeding2, when not confronted early on. On a global scale, the number of new HIV cases in children has decreased to 47%3, due to the increased availability of ART to pregnant women. Compliance with ART therapy is probably the main factor that ensures the best results of the therapeutic regimens4.
Communication between health professionals and HIV positive pregnant women is fundamental and essential for their compliance to ART. Therefore, trust relationships built between HIV positive pregnant women and health professionals are of great gravity5. Health professionals should demonstrate understanding and empathy and encourage them to express their fears and worries about the regimen and its impact on their health and that of their children. Furthermore, it is of great importance to respect these women and to recognize the difficulties they are going through. The set-up of support programs for HIV positive pregnant women in the hospitals is also essential, and helps their compliance to ART6.
The midwives who provide service to women are a trustworthy source of information and advice and, therefore, need to be actively involved in pharmacovigilance and pharmacoepidemiology networks, to receive comprehensive training in ART, and to be empowered to take responsibility for ensuring the generation of high-quality data in terms of ART during pregnancy and lactation. By building trust, they can also be an important source of care and supportive consultation for HIV/AIDS7. The acquirement of specialized knowledge of the disease by the midwives is of great importance, as is the empowerment of positive attitude to the programs of vertical transmission decrease8. Positive enhancement, empathy, and recognition of the special needs of the HIV-positive pregnant women by the midwives result in the continuation of care9. Furthermore, they also result in the enhancement of the communication and the support by the husband/partner and the family at the time of diagnosis and search of care10.
The holistic approach of HIV-positive pregnant women before and after childbirth is the fundamental point of guarantee for their compliance to ART. Therefore, health professionals should develop relationships that are based on mutual trust and respect to their needs and recognize in time the need to support people who must comply with the suggested ART regimen11. The cooperation between health professionals and the pregnant women and the ‘significant others’ of the supportive environment is required in order to decrease barriers when possible and enhance compliance to the therapy.
Compliance to ART is a complex behaviour, that is determined by factors that are related to the patient, the health professionals, and the health systems12-14. The role of health professionals and especially midwives towards compliance to the ART, is essential important for building trust and guaranteeing the smooth management of the disease.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported. V. G. Vivilaki reports she is the editor in chief of the EJM journal.
FUNDING
There was no source of funding for this research.
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval and informed consent were not required for this study.
DATA AVAILABILITY
Data sharing is not applicable to this article as no new data were created.
PROVENANCE AND PEER REVIEW
Commissioned; internally peer reviewed.
DISCLAIMER
The views and opinions expressed in this article are those of the authors.
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Data Availability Statement
Data sharing is not applicable to this article as no new data were created.