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Even if progressive efforts were made in Ethiopia, half of new HIV infections result from mother-to-child transmission. Limited studies assessed the level and factors of adherence that differ among different populations across the country. So, this study aimed to investigate the level and predictors of adherence to the prevention of mother-to-child transmission (PMTCT) Option B care among pregnant women in central Ethiopia. A facility-based cross-sectional study design was conducted to interview 347 HIV positive pregnant women. Using a multistage sa