AN ASSESSMENT OF CHALLENGES INFLUENCING ACCESS TO COMPREHENSIVE HIV CARE AMONG ADOLESCENTS AND YOUTH AGED 15-24 YEARS AT NAKURU COUNTY REFERRAL HOSPITAL IN KENYA
DOI:
https://doi.org/10.47672/ajhmn.544Keywords:
Comprehensive HIV Care, Adolescents, YouthAbstract
Purpose: Adolescents and youth living with HIV/AIDs experience numerous challenges and support needs, some of which occur in school and affect their quality of life. Several reasons have been advanced to explain this trend includes; stigma, peer pressure and discrimination. However, little focus has been made on socio-cultural, socioeconomic and clinical challenges facing Adolescents and Youth Living with HIV/AIDS (AYLHIV). The objective of this study was to assess the challenges influencing access to comprehensive HIV care among adolescents and youth aged 15-24 years at Nakuru county referral hospital in Kenya.
Methodology: Adopting social cognitive theory, a descriptive survey research design was used. Purposive and proportionate random sampling techniques were used to obtain a sample size of 47 AYLHIV. Questionnaires and focused group discussions were used to collect data from AYLHIV; while Interview schedules were to collect data from counsellors in November 2019. Data were analyzed by the use of descriptive statistics in January 2020.
Findings: The study concludes that the main socio-cultural challenges faced by AYLWA at County Referral Hospitals are stigma and frequent change of caregivers resulting in poor adherence to ARV medications. Moreover, no major socio-economic challenges were affecting AYLWA at the health facilities. Further, the main clinical challenges facing AYLWA were poor adherence and low viral suppression.
Unique Contribution to Theory, Practice and Policy: The study recommends the need to offer and strengthen psychosocial support to AYLWA to enable them to cope with their status and educate the caregivers on the importance of the AYLWA having a consistent caregiver for continuity. The hospital management should avail more trained adherence counsellors for this role. Moreover, the hospital management needs to strengthen the Youth Friendly HIV services to improve responsiveness to the youth needs. This will enhance peer support.
Downloads
References
Abubakar, A., Van de Vijver, F. J., Fischer, R., Hassan, A. S., Gona, J., Dzombo, J. T, Bomu, G., Katana, K., & Newton, C.R. (2016). Everyone has a secret they keep close to their hearts': challenges faced by adolescents living with HIV infection at the Kenyan coast. BMC Public Health, 16(1).
Ammon, N., Mason, S. & Corkery, J.M. (2018). Factors impacting antiretroviral therapy adherence among human immunodeficiency virus-positive adolescents in Sub-Saharan Africa: a systematic review.
Bakeera-Kitaka, S., Nabukeera-Barungi, N., Nöstlinger, C., Addy, K. & Colebunders, R. (2008). Sexual risk reduction needs of adolescents living with HIV in a clinical care setting. AIDS Care. 20(4), pp. 426-33.
Chhim, K., Mburu, G., Tuot, S., Sopha, R., Khol, V., Chhoun, P. & Yi, S. (2018). Factors associated with viral non-suppression among adolescents living with HIV in Cambodia: A cross-sectional study. AIDS research and therapy, 15(1). Retrieved from https://doi.org/10.1186/s12981-018-0205-z
Elizabeth Glaser Pediatric AIDS Foundation. (2018). 2nd International Workshop on HIV Adolescence. Cape Town, South - Africa.
Fleming, P., Byers, R. H. & Sweeney, P. A. (2010). HIV prevalence in the United States. Presented at the 9th Conference on Retroviruses and Opportunistic Infections. pp. 24-28.
Fournier, B., Bridge, A., Kennedy, A. P., Alibhai, A. & Konde-Lule, J. (2014). Hear our voices: a Photovoice project with children who are orphaned and living with HIV in a Ugandan group home. Child Youth Service, 55-63.
Gils, T., Bossard, C., Verdonck, K., Owiti, P., & Casteels, I. (2018). Stock-outs of HIV commodities in public health facilities in Kinsasha: Barriers to end HIV. Retrieved from https://doi.org/10.1371/journal.pone.0191294
Goldberg, R. E, & Short, S. E .A. (2016). What do we know about children living with HIV-infected or AIDS-ill adults in Sub-Saharan Africa? A systematic review of the literature.
Kim, M. H., Mazenga, A. C., Yu, X., Ahmed, S., Paul, M. E., Kazembe, P. N. & Abrams, E. J . (2017). High self-reported non-adherence to antiretroviral therapy amongst adolescents living with HIV in Malawi: barriers and associated factors. Journal of the International AIDS Society, 20(1). Retrieved from https://doi.org/10.7448/IAS.20.1.21437
Kimera, E., Vindevogel, S. & De - Maeyer, J. (2019). Challenges and support for quality of life of youths living with HIV/AIDS in schools and the larger community in East Africa: a systematic review. 64. Retrieved from https://doi.org/10.1186/s13643-019-0980-1
MacCarthy, S., Saya, U., Samba, C., Birungi, J., Okoboi, S. & Linnemayr, S. (2018). "How am I going to live?": exploring barriers to ART adherence among adolescents and young adults living with HIV in Uganda. BMC public health, 18(1). Retrieved from https://doi.or
Maskew, M. . (2016). "˜Insights into Adherence among a Cohort of Adolescents Aged 12-20 Years in South Africa: Reported Barriers to Antiretroviral Treatment' AIDS Research and Treatment.
Mesic, A., Halim, N., MacLeod, W., Haker, C., Mwansa, M. & Biemba, G. (2019). AIDS and Behavior. (9), pp 2618-2628.
Mutumba, M., Baumeister, J.A., Musiime, V., Byaruhanga, J., Francis, K., Snow, R. C, & Tsai, A. C. (2015). Psychosocial challenges and strategies for coping with HIV among adolescents in Uganda: A qualitative study. 86 - 94.
Mwangi, R., Ngure, M., Thiga, P. & Ngure, F. (2012). Factors Influencing the Utilization of Voluntary Counselling and Testing Services among University Students in Kenya. East African Medical Journal, 86(1), 11-15.
Mwau, M., Syeunda, C. A., Adhiambo, M., Bwana, P., Kithinji, L., Mwende, J., Oyiengo, L., Sirengo, M. & Boeke, C. E. (2018). Scale-up of Kenya's national HIV viral load program: Findings and lessons learned. PloS. Retrieved from https://doi.org/10.1371/journal.pone.0190659
Nabukeera-Barungi, N., Elyanu, P., Asire, B., Katureebe C., Lukabwe, I., Namusoke, E., Musinguzi, J., Atuyambe, L., & Tumwesigye, N. (2015). Adherence to antiretroviral therapy and retention in care for adolescents living with HIV from 10 districts in Uganda. 15.
Naswa, S. & Marfatia, Y. S. (2010). Adolescent HIV/AIDS: issues and challenges. Indian journal of sexually transmitted diseases, 31, 1-10. Retrieved from 10.4103/0253-7184.68993.
NIDA. (2012). Comprehensive National Health Policy Framework 2011-2030. Retrieved from https://www.drugabuse.gov/publications/research-reports/hivaids on 2020
OlubusayoAduke, A. & Kesh, M. (2015). A case study of school support and the psychological, emotional and behavioural consequences of HIV and AIDS on adolescents. Journal of Social Aspects of HIV/AIDS, 12(1), 123-133. Retrieved from DOI: 10.1080/17290376.201
Othero, D. M., Aduma, P. & Opil, C. O. (2009). Knowledge, attitudes and sexual practices of university students for advancing peer HIV education. East African Medical Journal, 86(1), 11-15.
Paul D. M. M. & Elizabeth. D. (2015). Communities in Crisis: Is There a Generalized HIV Epidemic in Impoverished Urban Areas of the United States?; fast-Track Plan to End HIV and AIDS Among Adolescents and Young People.
Project, Food and Nutrition Technical Assistance (FANTA). (2012). HIV/AIDS: A guide for nutritional care and support. Retrieved from http://www.fantaproject.org
Ramaiya, M. K., Sullivan, K. A., O'Donnell, K., Cunningham, C. K., Shayo, A. M., Mmbaga, B. T. & Dow, D. E. (2016). A qualitative exploration of the mental health and psychosocial contexts of HIV-positive adolescents in Tanzania. 11(11).
Thapa, R., Amatya, A. & Pahari, D. P. (2015). Nutritional status and its association with quality of life among people living with HIV attending public anti-retroviral therapy sites of Kathmandu Valley, Nepal. 14(12). Retrieved from https://doi.org/10.11
UNAIDS. (2014). Global AIDS response progress reporting 2014. Retrieved August 22, 2015, from www.unaids.org/sites/default/files/media_asset/GARPR_2014_guidelines_en_0.pdf
Wiens MO, MacLeod S, Musiime, V., Ssenyonga, M., Kizza, R., Bakeera-Kitaka, S., Odoi-Adome, R. & Ssali, F. (2012). Adherence to antiretroviral therapy in HIV-positive adolescents in Uganda assessed by multiple methods: A prospective cohort study. 331 - 335.
World Health Organization (WHO) and UNAIDS UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access- Progress Report, World Health Organization (WHO). Geneva, Switzerland.
Yin, R. K. (2003). Case study research design and methods third edition. Applied social research methods series. 5.
Zakumumpa, H., Kiweewa, F. M. & Khuluza, F. (2019). "The number of clients is increasing but the supplies are reducing": provider strategies for responding to chronic antiretroviral (ARV) medicines stock-outs in resource-limited settings: a qualitative study from Uganda. 19(312). Retrieved from https://doi.org/10.1186/s12913-019-4137-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Chirchir Matthew Kimeli, Eddah Cheruiyot, James Waweru, Richard Sumukwo, Nanyorri Nalama, Anne Owido, John Kamau Muigu, Lucy Kilisio, Monicah Nthiani, Michael M. Gachini, Marcia Kimarua, Monicah Kiratu, David Bett
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.