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) |