Publications

Communication between HIV-infected children and their caregivers about HIV medicines: a cross-sectional study in Jinja district, Uganda

Abstract
Introduction

Knowledge of antiretroviral therapy (ART) among children with HIV depends on open communication with them about their health and medicines. Guidelines assign responsibility for communication to children's home caregivers. Other research suggests that communication is poor and knowledge about ART is low among children on treatment in low-income countries. This study sought to describe communication about medicine for HIV in quantitative terms from the perspectives of both children and caregivers. Thereafter, it established the factors associated with this communication and with children's knowledge about their HIV medicines.

Methods

We undertook a cross-sectional survey of a random sample of 394 children with HIV on treatment and their caregivers at nine health facilities in Jinja District, Uganda. We assessed reported frequency and content of communication regarding their medicines as well as knowledge of what the medicines were for. Logistic regression analysis was used to determine the factors associated with communication patterns and children's knowledge of HIV medicines.

Results

Although 79.6% of the caregivers reported that they explained to the children about the medicines, only half (50.8%) of the children said they knew that they were taking medicines for HIV. Older children aged 15–17 years were less likely to communicate with a caregiver about the HIV medicines in the preceding month (OR 0.5, 95% CI 0.3–0.7, p=0.002). Children aged 11–14 years (OR 6.1, 95% CI 2.8–13.7, p<0.001) and 15–17 years (OR 12.6, 95% CI 4.6–34.3, p<0.001) were more likely to know they were taking medicines for HIV compared to the younger ones. The least common reported topic of discussion between children and caregivers was “what the medicines are for” while “the time to take medicines” was by far the most mentioned by children.

Conclusions

Communication about, and knowledge of, HIV medicines among children with HIV is low. Young age (less than 15 years) was associated with more frequent communication. Caregivers should be supported to communicate diagnosis and treatment to children with HIV. Age-sensitive guidelines about the nature and content of communication should be developed.

Keywords: children with HIV, antiretroviral therapy, HIV disclosure, therapeutic communication, Uganda

Phoebe Kajubi,§,1 Susan Whyte,*,2 Simon Muhumuza,*,1 David Kyaddondo,*,1 and Anne R Katahoire*,1

Young people with HIV attending a transition clinic in Kampala, Uganda: An exploratory study of social context, illness trajectories, and pathways to HIV testing and treatment

Abstract 

Despite global improvements in antiretroviral treatment (ART) access, little is known about how young people with HIV initially enter treatment.

This article explores young people's trajectories towards HIV treatment: how, when, and with whom testing and treatment decisions are made and the role of adolescents themselves in this process. In 2009, we conducted 20 in-depth interviews with male and female adolescents attending the HIV/AIDS Transition Clinic at the Infectious Diseases Institute in Mulago Hospital, Kampala, Uganda. Interviews were audio recorded and transcribed. The authors read the transcripts, developed codes and synthesized themes.

Though many respondents were likely infected with HIV at birth, most tested and learned their serostatus as teenagers after repeated illnesses or perceived risky sexual behaviour. Young people encountered both obstacles and opportunities in their HIV treatment-seeking efforts. Caregivers' decisions and actions or an absence of spe- cialist HIV services and skills caused delays in ART enrolment. Health workers played an important role in referral and connecting young people to care.

The agency of young people themselves, once they realised that their illness could be HIV, was also crucial in ensuring prompt HIV testing and treatment-seeking. Young people who believed they were infected through mother-to-child transmission saw themselves as innocent victims and appeared mo- tivated to combat HIV, while those suspecting sexual transmission found disclosure to parents difficult and de- scribed feelings of guilt, regret, and self-blame. Understanding pathways to HIV testing and treatment can inform care and support services for young people in Uganda. In particular, earlier disclosure may facilitate pos- itive coping strategies and engagement in care. © 2016 Elsevier Ltd. All rights reserved.

Godfrey E. Siu, Caitlin E. Kennedy , Sabrina Bakeera-Kitaka

Relationship dynamics and sexual risk behaviour of male partners of female sex workers in Kampala, Uganda.

Martin Mbonye, Godfrey E Siu, Thadeus Kiwanuka & Janet Seeley

Prevalence of arrhythmias among children below 15 years of age with congenital heart diseases attending Mulago National Referral Hospital, Uganda

Anthony BatteEmail author, Peter Lwabi, Sulaiman Lubega, Sarah Kiguli, Violette Nabatte and Charles Karamagi

Patterns of treatment-seeking behaviors among caregivers of febrile young children: a Ugandan multiple case study.

Rosemin KassamEmail author, Richard Sekiwunga, Duncan MacLeod, Juliet Tembe and Eric Liow

A Review of a Project on Improving the Health and Nutrition of Women Community Health Care Providers in Two Communities in Uganda.

Assoc Prof Katahoire R. Anne; Kajubi Phoebe, Kyaligonza G.

Assets and challenges facing caregivers when managing malaria in young children in rural Uganda

Rosemin Kassam1*, John Collins2 and Richard Sekiwunga3

Quality of inpatient pediatric case management for four leading causes of child mortality at six government-run Ugandan hospitals.

Sears D, Mpimbaza A, Kigozi R, Sserwanga A, Chang MA, Kapella BK, et al. PLoS One. 2015;10(5):e0127192.