Bulletin of the World Health Organization

Survey of children accessing HIV services in a high prevalence setting: time for adolescents to count?

Rashida Ferrand, Sara Lowe, Barbra Whande, Lucia Munaiwa, Lisa Langhaug, Frances Cowan, Owen Mugurungi, Diana Gibb, Shungu Munyati, Brian G Williams & Elizabeth L Corbett

Volume 88, Number 6, June 2010, 428-434

Table 1. Main problems, as reported by clinic staff, faced by HIV-infected young children and adolescents, Zimbabwe, 2008

Problems No. of clinics (%)
n  =  108
n  =  113
Young children
(0–5 years)
Adolescents
(10–19 years)
Psychosocial issues 6 (6) 63 (56)
Stigma 1 15
Denial (guardian/patient) 3 4
Schooling 0 12
Emotional and psychological 1 16
Guardian not coping 1 0
Puberty/future planning/peer pressure 0 11
Responsibility for siblings 0 5
Erratic drug taking 37 (34) 41 (36)
Poor attendance to clinic appointments 19 9
Poor adherence to collected medicines 18 32
Lack of resources (clinic level) 16 (15) 37 (33)
Paediatric clinical services 4 6
Trained staff 1 1
Space/material resources 3 5
Counselling 8 13
Psychosocial support services 0 12
Lack of disclosure of HIV status 4 (4) 24 (21)
Malnutrition 50 (46) 23 (20)
Orphanhood 23 (21) 17 (15)
Caregiver issues 40 (37) 17 (15)
Multiple/changing caregivers 11 4
Elderly caregiver 6 1
Ill parent/caregiver 4 0
Unsupportive/negligent caregiver 19 12
Economic difficulties 22 (20) 17 (15)
Transport fares 11 8
Money for food/medicines/school fees 11 9
Unavailability of drugs 43 (40) 13 (12)
Paediatric formulations 19 1
Drug shortages 24 12
Sexual health issues 1(1) 9 (8)
Unsafe sex/rape 1 7
Lack of sexual health services 0 2
Diagnosis of HIV infection 16 (15) 9 (8)
Lack of guardian consent 6 7
Lack of diagnostic tests 9 0
Lack of counselling and testing 1 2
Presentation with advanced disease 5 (5) 3 (3)
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