“I have been rejected so many times” experiences of female adolescents living with HIV in rural Manzini, Eswatini: A case study

Nsibandze, Bonisile S.; Downing, Charlené; Poggenpoel, Marie; Myburgh, Chris

doi:10.1016/j.ijans.2021.100307

Cited by 9 publications

(7 citation statements)

References 38 publications

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“…They alluded to overcrowding, long waiting periods, and lack of privacy as negative experiences at the clinic. The findings support the evidence from prior research [11], [12] where adolescents described revisiting the clinic as a cumbersome process sometimes due to long waiting periods and so much time spent at the clinic.…”

Section: Discussionsupporting

confidence: 87%

Lived experiences of adolescents living with human immuno- deficiency virus in Namibia

Mukerenge

Schmollgruber

2023

IJPHS

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Adolescents living with human immunodeficiency virus (HIV) experience stigma, ill-treatment, and many other challenges due to their health condition. Their experience with HIV is highly overlooked, yet, it shapes their decisions and influences their health outcomes. The objective of this study was to explore and describe the lived experiences of adolescents living with HIV in the Namibian context. We conducted a qualitative study of adolescents (aged 10-19 years) at five different anti-retroviral treatment (ART) clinics in Rundu district, Kavango region Namibia. We used purposive sampling and collected data through in-depth interviews with 21 adolescents from October 2020 to December 2020. We analyzed the data with content analysis. The mean age of participants was 16 years, and the age ranged between 12-19 years. Most participants (62%) have never been in a relationship or engaged in sexual activities. All the participants were in school at the time of the study. The content analysis yielded five broad categories: i) experience with HIV care and treatment, ii) finding out about HIV Status, iii) the interplay between HIV and social relationships, iv) the need for information on HIV and the treatment, v) multiple fears, worries, and means to cope. Adolescents living with HIV (ALWH) experience many challenges due to their health condition. Learning about their HIV status is one of the most challenging experiences. There is a need for continued HIV care and support for adolescents living with HIV, which is adolescent- friendly and focused.

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Section: Discussionsupporting

confidence: 87%

Lived experiences of adolescents living with human immuno- deficiency virus in Namibia

Mukerenge

Schmollgruber

2023

IJPHS

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“…This group may have poor access to care, which may lead to delays in establishing workable ART medication routines and hence poor adherence at the start. 47 There was no significant association between knowledge of HIV status and the categorization into 4 adherence trajectories. This may be partly explained by the fact that the majority of adolescents already knew their HIV status at baseline 36 and the potential confounding effects of age at ART initiation and the duration of ART 48 or that the disclosure process or pattern may influence adherence more than knowledge of status.…”

Section: Discussionmentioning

confidence: 87%

Longitudinal Trajectories of Antiretroviral Treatment Adherence and Associations With Durable Viral Suppression Among Adolescents Living With HIV in South Africa

Zhou,

Cluver,

Knight

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Compared with other age groups, adolescents living with HIV (ALHIV) are estimated to have lower levels of adherence to antiretroviral treatment. Despite this, we lack evidence on adolescents' adherence patterns over time to inform the customization of intervention strategies. Setting: Eastern Cape province, South Africa. Methods: We analyzed data from a cohort of ALHIV (N = 1046, aged 10–19 years at baseline) recruited from 53 public health facilities. The cohort comprised 3 waves of data collected between 2014 and 2018 and routine viral load data from the National Institute for Communicable Disease data warehouse (2014–2019). Durable viral suppression was defined as having suppressed viral load (<1000 copies/mL) at ≥2 consecutive study waves. Group-based multitrajectory model was used to identify adherence trajectories using 5 indicators of self-reported adherence. Logistic regression modeling evaluated the associations between adherence trajectories and durable viral suppression. Results: Overall, 933 ALHIV (89.2%) completed all 3 study waves (55.1% female, mean age: 13.6 years at baseline). Four adherence trajectories were identified, namely, “consistent adherence” (49.8%), “low start and increasing” (20.8%), “gradually decreasing” (23.5%), and “low and decreasing” (5.9%). Adolescents experiencing inconsistent adherence trajectories were more likely to be older, live in rural areas, and have sexually acquired HIV. Compared with the consistent adherence trajectory, the odds of durable viral suppression were lower among adolescents in the low start and increasing (adjusted odds ratio [aOR]: 0.62, 95% CI: 0.41 to 0.95), gradually decreasing (aOR: 0.40, 95% CI: 0.27 to 0.59), and the low and decreasing adherence (aOR: 0.25, 95% CI: 0.10 to 0.62) trajectories. Conclusions: Adherence to antiretroviral treatment remains a challenge among ALHIV in South Africa. Identifying adolescents at risk of nonadherence, based on their adherence trajectories may inform the tailoring of adolescent-friendly support strategies.

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“…To reduce the effects of children growing up without parents, grandparents should be encouraged and supported to take on caregiving duties and parental roles for the grandchildren [61]. Also, findings from this study can be generalised to a bigger population as a result of the sample scope included in this study [59,64]. Additionally, in-depth research is required to identify the difficulties and issues that are being faced by grandparents as caregivers, especially in this era of both noncommunicable and communicable diseases, such as tuberculosis and HIV/AIDS [19,42], considering the high prevalence of young parents of children who are out of work [61,62].…”

Section: Discussionmentioning

confidence: 96%

“Health Outcomes of Grandparents Caring for Double Orphans in South Africa”: What Are the Determinants?

Likoko,

Akokuwebe,

Osuafor

et al. 2023

IJERPH

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In the 21st century, grandparenthood is a significant phenomenon in the fields of demography, gerontology, and sociology. It is mainly explored in the context of ageing, as it is poised to become one of the most significant demographic phenomena and social issues in contemporary South Africa. Therefore, this study examined the determinants associated with grandparents who are parenting as caregivers and the health challenges they are exposed to as caregivers. The National Income Dynamics Study (NIDS) Wave 5 dataset was utilised, and a total of 302,476 grandparents aged 25 years and older, who were reported to be primary caregivers of double orphans, were included in the analysis. Both bivariate and multivariate binary logistic regressions were performed to determine the predictors of the determinants of grandparents parenting as caregivers and their health challenges in South Africa. Estimated odds ratios (ORs) with 95% confidence intervals (CIs) were used, and the threshold for statistical significance was established at ρ < 0.05. A majority of the male and female grandparent caregivers were aged 24–34 years, were Black Africans (69.8%), had secondary education (46.9%), reported health challenges (HC) (59.7%), with 26.4% reporting headaches in the last 30 days. Logistic regression revealed that grandparent caregivers aged 55–64 years were 8.9 times more likely to report health challenges compared to those aged 25–34 years. Non-Black African grandparent caregivers were found to be 0.61 times less likely to report health challenges, compared to Black African grandparent caregivers. Those with perceived poor health status were 3.3 times more likely to report health challenges, compared to those with excellent perceived health status. Therefore, there is an urgent need to redesign health interventions to address these health burdens among grandparent caregivers and to take cognisance of providing economic and social support for these vulnerable populations.

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“I have been rejected so many times” experiences of female adolescents living with HIV in rural Manzini, Eswatini: A case study

Cited by 9 publications

References 38 publications

Lived experiences of adolescents living with human immuno- deficiency virus in Namibia

Lived experiences of adolescents living with human immuno- deficiency virus in Namibia

Longitudinal Trajectories of Antiretroviral Treatment Adherence and Associations With Durable Viral Suppression Among Adolescents Living With HIV in South Africa

“Health Outcomes of Grandparents Caring for Double Orphans in South Africa”: What Are the Determinants?

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