Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana

Kenu, Ernest; Obo-Akwa, Adjoa; Nuamah, G.B.; Brefo, Anita; Sam, Miriam; Lartey, Margaret

doi:10.1186/1756-0500-7-844

Cited by 30 publications

(24 citation statements)

References 14 publications

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“…Similar to the current study UNICEF reported that the overall level of know- [23]. Interestingly to note that similar findings were reported in Ghana that 47% of adolescents on cART had no knowledge about the HIV disease and its progression [44]. These similarities could mean that adolescents have common interests and aspiration despite geographical variation.…”

Section: Knowledge Of Hiv and Disease Progressionsupporting

confidence: 86%

Factors Influencing Adherence to Antiretroviral Therapy among HIV Positive Adolescents at Adult Infectious Diseases Center in Lusaka, Zambia

Namoomba¹,

Makukula²,

Masumo³

2019

OJN

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Background: Non-adherence to combination antiretroviral therapy leads to drug resistance, treatment failure and increased morbidity and mortality among HIV positive adolescents. The aim of this study was to assess factors influencing adherence to combination antiretroviral therapy among HIV positive adolescents at Adult Infectious Disease Center in Lusaka, Zambia. Methodology: A descriptive quantitative cross sectional study was conducted on 173 adolescent respondents on antiretroviral therapy who were selected using a systematic random sampling method. Data was collected using the questionnaires with the adopted Morisky drug adherence scale and analyzed using Statistical Package for the Social Sciences software, version 20. Chi square, fishers' exact statistical tests and the binary logistic regression model were used to determine true predictors and to adjust confounders of adherence. The cut off point for statistical significance was set at 5%. Results: This study established that 76 (43.9%) of the respondents were non-adherent to their antiretroviral therapy. Knowledge of HIV and disease progression was reported to be low but had no statistical impact on antiretroviral therapy adherence. Stigmatization was high (99 (57.2%)) but did not significantly influence adherence to combination antiretroviral therapy on the study participants. Factors which were found to be statistically significant to adherence to therapy when a binary logistic regression was performed were experiencing side effects to therapy (p-value 0.047, odds ratio = 0.412); understanding reason for taking combination antiretroviral therapy (p-value 0.006, odds ratio = 5.978) and being reminded to take drugs (p-value 0.006, odds ratio = 0.505). Conclusion: The study found that there was high level of non-adherence to combination antiretroviral therapy which could subsequently lead to

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Section: Knowledge Of Hiv and Disease Progressionsupporting

confidence: 86%

Factors Influencing Adherence to Antiretroviral Therapy among HIV Positive Adolescents at Adult Infectious Diseases Center in Lusaka, Zambia

Namoomba¹,

Makukula²,

Masumo³

2019

OJN

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“…This programme incorporated behavioural, cognitive and psychosocial strategies; a combination of interventions which appeared to foster adherence among adolescent participants [ 216 ]. In relation to these, education-focused strategies targeted at improving health literacy concerning HIV and ART use have been found to potentially improve adherence behaviour among youth in African countries including Ghana, Botswana and South Africa [ 217 – 220 ], similar to findings among similar populations in well-resourced settings [ 221 – 223 ].…”

Section: Discussionmentioning

confidence: 84%

Contemporary issues on the epidemiology and antiretroviral adherence of HIV‐infected adolescents in sub‐Saharan Africa: a narrative review

Adejumo

Malee

Ryscavage

et al. 2015

Journal of the International AIDS Society

209

224

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IntroductionAdolescents are a unique and sometimes neglected group in the planning of healthcare services. This is the case in many parts of sub-Saharan Africa, where more than eight out of ten of the world's HIV-infected adolescents live. Although the last decade has seen a reduction in AIDS-related mortality worldwide, largely due to improved access to effective antiretroviral therapy (ART), AIDS remains a significant contributor to adolescent mortality in sub-Saharan Africa. Although inadequate access to ART in parts of the subcontinent may be implicated, research among youth with HIV elsewhere in the world suggests that suboptimal adherence to ART may play a significant role. In this article, we summarize the epidemiology of HIV among sub-Saharan African adolescents and review their adherence to ART, emphasizing the unique challenges and factors associated with adherence behaviour.MethodsWe conducted a comprehensive search of online databases for articles, relevant abstracts, and conference reports from meetings held between 2010 and 2014. Our search terms included “adherence,” “compliance,” “antiretroviral use” and “antiretroviral adherence,” in combination with “adolescents,” “youth,” “HIV,” “Africa,” “interventions” and the MeSH term “Africa South of the Sahara.” Of 19,537 articles and abstracts identified, 215 met inclusion criteria, and 148 were reviewed.DiscussionAdolescents comprise a substantial portion of the population in many sub-Saharan African countries. They are at particular risk of HIV and may experience worse outcomes. Although demonstrated to have unique challenges, there is a dearth of comprehensive health services for adolescents, especially for those with HIV in sub-Saharan Africa. ART adherence is poorer among older adolescents than other age groups, and psychosocial, socio-economic, individual, and treatment-related factors influence adherence behaviour among adolescents in this region. With the exception of a few examples based on affective, cognitive, and behavioural strategies, most adherence interventions have been targeted at adults with HIV.ConclusionsAlthough higher levels of ART adherence have been reported in sub-Saharan Africa than in other well-resourced settings, adolescents in the region may have poorer adherence patterns. There is substantial need for interventions to improve adherence in this unique population.

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“…Special attention is needed for HIV caregivers and their HIV-positive adolescents in rural Mainland China and elsewhere. In a similar manner to HIV/AIDS Community Healthcare Workers centres/programs (Kenu et al, 2014;Persson, Newman, & Miller, 2014) these centres have the potential to reduce HIV transmission and increase compliance with ART globally.…”

Section: Discussionmentioning

confidence: 99%

Secrets, shame and guilt: HIV disclosure in rural Chinese families from the perspective of caregivers

Wong

Holroyd

Miu

et al. 2017

Vulnerable Children and Youth Studies

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This in-depth ethnographic study examines the processes, barriers and impacts experienced by Mainland Chinese caregivers residing in rural Yunnan for disclosing HIV status to their adolescents born with the infection and other community members. In particular, highlighted are their associated personal, social, relational and cultural vulnerabilities. A purposeful sample of 13 pairs of HIV-born adolescents between the ages of 11–19 years and their primary caregivers were recruited in December 2014. The Conceptual Model Sexual Health Disclosure (CMSHD) was modified with Chinese culturally specific adaptation to guide the exploration of the complex aspects of the adolescents and caregiver’s relationships. All interviews were audiotaped, transcribed verbatim and then translated into English. Complex sociocultural interactions emerging in these dyadic interviews included guilt, shame, unintended disclosure, the need for secrecy, perceived stigma, ‘loss of face’, protection of parents, inability to support their families and deep concerns over lineage and future marriage prospects amongst the parents, which had significant psychosocial and even physical impacts for these adolescents born with HIV and their families. Frontline health-care workers and HIV peer support programs are recommended to counteract China’s current top-down biomedical disease-related approach to health services. It is crucial to provide instrumental avenues of confidential psychosocial support including disclosure approaches for caregivers of HIV positive adolescents within a uniquely Chinese cultural context

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Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana

Cited by 30 publications

References 14 publications

Factors Influencing Adherence to Antiretroviral Therapy among HIV Positive Adolescents at Adult Infectious Diseases Center in Lusaka, Zambia

Factors Influencing Adherence to Antiretroviral Therapy among HIV Positive Adolescents at Adult Infectious Diseases Center in Lusaka, Zambia

Contemporary issues on the epidemiology and antiretroviral adherence of HIV‐infected adolescents in sub‐Saharan Africa: a narrative review

Secrets, shame and guilt: HIV disclosure in rural Chinese families from the perspective of caregivers

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