Getting to 90–90–90 targets for children and adolescents HIV in low and concentrated epidemics

Chamla, Dick

doi:10.1097/coh.0000000000000264

Cited by 16 publications

(11 citation statements)

References 21 publications

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“…Similar studies to assess barriers to achieving the UNAIDS 90-90-90 targets have been done elsewhere and also agree with our findings. For instance in the Asia Pacific region, the barriers identified were similar to those in our study and were classified as political, demographic, socioeconomic, and health system factors [ 44 ].…”

Section: Discussionmentioning

confidence: 62%

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

Bajunirwe

Tumwebaze

Akakimpa

et al. 2018

BioMed Research International

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Background UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts. Data were also collected from focus group discussions comprised of clients presenting for HIV care and treatment. Data were transcribed and analyzed using content analysis. Results. Barriers identified were as follows: (1) drug shortages including antiretroviral drugs at health facilities. Some patients were afraid to start ART because of worrying about shortages; (2) distance and (3) staffing shortages; (4) stigma persistence; (5) lack of social and economic support initiatives that enhance retention in treatment. Conclusions In conclusion, our study has identified several factors that influence access, availability, and utilization of HIV services. Programs need to address drug and staff shortages, HIV stigma, and long distances to health facilities to broaden access and utilization in order to realize the UNAIDS target.

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Section: Discussionmentioning

confidence: 62%

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

Bajunirwe

Tumwebaze

Akakimpa

et al. 2018

BioMed Research International

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“…Two-thirds of all PLWHA including 85% of HIV-infected children reside in sub-Saharan Africa (SSA). (WHO, 2015) Among children and adolescents in Africa, AIDS-related illness remains the leading cause of death (Kisesa & Chamla, 2016) and thus the need for specific investigation of HIV-related QOL differences in the region. Investigations of both HIV and toxic stress as determinants of QOL outcomes among African PLWHA are few.…”

Section: Introductionmentioning

confidence: 99%

Toxic Stress and Quality of Life in Early School‐Aged Ugandan Children With and Without Perinatal Human Immunodeficiency Virus Infection

Ezeamama

Zalwango

Tuke

et al. 2020

New Directions for Child and Adolescent Development

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Caregiver's and child's self‐reported quality of life (QOL) was defined using standardized questionnaires in a sample (N = 277) of 6–10 years old HIV‐infected, HIV‐exposed uninfected, and HIV‐unexposed uninfected children from Uganda. Psychosocial stress (acute stress and cumulative lifetime adversity) and physiologic stress (dysregulations across 13 biomarkers), perinatal HIV status, and their interaction were related to child QOL via general linear models. Lower child‐ and caregiver‐reported psychosocial stress were dose‐dependently associated with higher QOL (acute stress: mean difference coefficient b = 8.1–14.8, effect size [ES] = 0.46–0.83). Lower allostasis was dose‐dependently associated with higher QOL (b = 6.1–9.7, ES = 0.34–0.54). Given low caregiver acute stress, QOL for HIV‐infected was similar to HIV‐uninfected children; however, given high caregiver acute stress, a QOL disadvantage (b = −7.8, 95% CI: −12.8, −2.8; ES = −0.73) was evident for HIV‐infected versus uninfected children. Testing of caregiver stress reduction interventions is warranted to increase wellbeing in dependent children.

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“…Despite the high rate of adherence to clinical treatment, it is important to note that, as of 2018, the Asia-Pacific region still has the second largest number of HIV-positive individuals after Africa, at 5.2 million people [ 17 ]. Because epidemics in Asia are deemed ‘concentrated’ while those in most of the southern and parts of eastern Africa are ‘generalized’ [ 25 , 26 , 27 ], different approaches are needed. In a qualitative study, HIV-infected patients in India have pointed to the cost of ART as a major barrier, while also noting privacy and stigma issues, such as the disclosure of HIV inhibiting pill-taking and social support [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

The Dark Side of Female HIV Patient Care: Sexual and Reproductive Health Risks in Pre- and Post-Clinical Treatments

Khuat

Nguyen

et al. 2018

JCM

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This study examines the pre- and post-clinical issues in human immunodeficiency virus (HIV) care and treatment for women and girls of high-risk population groups—namely sex workers, injecting drug users, women living with HIV, primary sexual partners of people living with HIV, adolescent girls who are children of these groups, and migrant young girls and women—in five provinces and cities in Vietnam. Through a sample of 241 surveyed participants and 48 respondents for in-depth interviews and 32 respondents in the focus group discussions, the study identifies multiple barriers that keep these groups from receiving the proper health care that is well within their human rights. Most respondents rated HIV testing as easily accessible, yet only 18.9% of the surveyed women living with HIV disclosed their infection status, while 37.8% gave no information at the most recent prenatal care visit. The level of knowledge and proper practices of sexual and reproductive health (SRH) care also remains limited. Meanwhile, modern birth control methods have yet to be widely adopted among these populations: only 30.7% of respondents reported using condoms when having sex with their husband. This increases the risks of unwanted pregnancy and abortion, as well as vulnerability to sexually transmitted infections (STIs) and HIV transmission. On the other hand, HIV-related stigma and discrimination at health care settings are still pervasive, which create significant barriers for patients to access proper care services. Based on these results, six recommendations to improve SRH status of women and girls of populations at high risk are put forward.

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Getting to 90–90–90 targets for children and adolescents HIV in low and concentrated epidemics

Cited by 16 publications

References 21 publications

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

Toxic Stress and Quality of Life in Early School‐Aged Ugandan Children With and Without Perinatal Human Immunodeficiency Virus Infection

The Dark Side of Female HIV Patient Care: Sexual and Reproductive Health Risks in Pre- and Post-Clinical Treatments

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