5th NATIONAL PAEDIATRIC HIV/AIDS CONFERENCE 28-30th Hotel Africana, Kampala-Uganda

Presentation Title: Awareness about Paediatric HIV Services in Uganda

Authors: Simon Ndizeye, Robert Nangai, Esther Kaggwa, Cheryl Lettenmaier and Ruth Musekura

Organization: Centre for Communication Programs/Health Communication Partnership

Overview

• Over 130,000 children under 14 years are living with HIV in Uganda (0.7% prevalence) (UNSBS-04/05).

• Only 17% (13,413/76,000) are enrolled as of Sept. 2009. (WHO/UNAIDS/UNICEF, 2010)

• Low uptake of ART is partly due to limited awareness among caretakers that children can be tested and treated for HIV.

• Most health care workers lack the skills to identify, treat and care for children at risk of HIV and to counsel/provide psycho-social support for HIV-positive children and their caregivers.

JHU.CCP/HCP roles

• JHU.CCP/HCP and RCQHC have been providing technical support to the MoH in terms of training, community mobilization and communication for paediatric HIV/AIDS services.

• As a result, the paediatric HIV/AIDS communication strategy was updated and a community mobilization strategy designed and shared with partners.

• Client education materials development, mapping of services, development of national training curriculums and training of HWs are some of the key activities undertaken to address to gaps.

Methodology:

• Between Nov-Dec’ 2010, HCP conducted a survey to evaluate the impact of HCP activities while at the same providing baseline measures for activities that are just beginning and will be implemented over the next 2 years

• The survey was also meant to gather information about the knowledge, attitudes, and behaviors among respondents for HCP-supported communication initiatives

Methodology:

• The study was cross sectional in nature, covering 31 Districts across Uganda and reached 2,896 individuals aged 15-54 years residing in 360 parishes (EAs) in 31 new districts

Used a multi stage stratified sampling approach with 2 separate sampling frames; for YP aged 15-24 and for adults 25-54

• Analysis was conducted in STATA 10 using univariate, bivariate and multivariate techniques.

Key Findings

Characteristics Number Percentage

No. of respondents 2,896

MaleFemale

1,3791,517

4852

15-2425-49

1,4831,413

5149

RuralUrbanKampala

2,174722423

752515

EastNorthWestCentral

665890594747

23312126

• 44% of the respondents had seen or heard about paed HIV messages.

• Females from urban areas and with secondary + education more likely to have seen or heard the messages.

Exposure to messages on Paediatric HIV by Selected Characteristics

42 4639

60

36

55

44

010203040506070

Male

Female

Rural

Urban

Pri&Below

2ndary+ Total

Perc

ent

N = 1275All P < 0.05

Sources of Paediatric HIV Messages

N = 1275

79

2210

5 4 2 2 10

20

40

60

80

Perc

enta

ge o

f Res

pond

ents

Knowledge of a place where HIV +ve children can be treated and selected background

characteristics• 59% knew of a place

where HIV+ children can be treated.

• Those exposed to paediatric HIV messages, urban residents, employed and those with secondary + education more likely to know of a place.

• Age and marital status not statistically significant.

78

4556

68

5467

59

0102030405060708090

Expose

d

Unexpose

dRural

Urban

Pri&Below

2ndary+ Total

Perc

ent

N = 2,860All P < 0.05Educ OR 1.6

Employment OR 1.5

Exp to messages OR 4.2

Places where HIV+ Children can be treated

1495

37

73

0

20

40

60

80

100

Gov't Hosp. Gov't HC PvtHosp/Clinic

TASO AIC JCRC

N = 1,696

Perceived appropriateness of ARVs for HIV positive children

• Overall 37% of the respondents thought ARVs should be given to babies under 2 yrs; 53% to children btn 2-5 years.

• The older the child the more likely respondents thought it should be given ARVs.

37 3539

5350

57

0

10

20

30

40

50

60

Overall Males Females

Babies under 2 yrs Children btn 2 -5 yrs

N = 2,343

Conclusions

• Knowledge levels on the use of ARVs in treating HIV-positive children, as well as the location and availability of paediatric HIV services are still considerably low.

• Exposure to media messages about paediatric HIV treatment is significantly associated with higher knowledge levels on appropriateness of ART for HIV positive children and availability of paediatric HIV services.

Recommendation• There is need for Ministry of Health and its

partners to intensify peadiatric HIV/AIDS communication efforts to expand reach of information about the available services and appropriateness of ART for HIV positive children which will in the long run increase up take of the services.

Acknowledgements

•Ministry of Health•ART Partners•USAID• PEPFAR•RCQHC