The Human Immunodeficiency Virus and the resultant disease—Acquired Immune Deficiency Syndrome are global epidemics in recent times. Although the effects of the epidemic have been curtailed somewhat in the developed ...The Human Immunodeficiency Virus and the resultant disease—Acquired Immune Deficiency Syndrome are global epidemics in recent times. Although the effects of the epidemic have been curtailed somewhat in the developed world, it is not so in developing countries. As such it affects not only the infected but those directly dependent on them. Some of the affected people have been identified as children, who turn out to be unprepared for and defenceless against the imminent hardship prevalent as a consequence of the disease. The effects of the epidemic are felt more in the developing world than in developed countries and this is because the attitude of the developed world to the epidemic is positive, enhanced by awareness of the disease;whereas in the developing countries, a lot of myths are attached to it, affecting the requisite attitude needed to combat the epidemic and its effects. This paper seeks to examine the effects of this epidemic on children in Nigeria, comparing the effects on children in other African countries. The paper also looks at structures in place to cater for these children, and then seeks to proffer improved means of protecting their rights.展开更多
This study aimed to research the living status and support system of children orphaned by AIDS in rural Henan Province. The approach of face-to-face questionnaires research was used to assess 501 children’s current s...This study aimed to research the living status and support system of children orphaned by AIDS in rural Henan Province. The approach of face-to-face questionnaires research was used to assess 501 children’s current situation while in-depth interview was conducted for the support system research. The age range of the children orphaned by AIDS was 2 - 15 years old and the mean age was 11.10 years. Most children among 2 - 6 years had communication skills with temper control and psychological problems. Children of 7 - 15 years old had the ability to take care of themselves and family members but could not do self-regulation. The support system for children orphaned by AIDS included social support, policies support, education support, and health care support but improvement are needed in the future. Support system can be improved through much more feasible and concrete policies and strategies to guarantee these children’s basic needs and comprehensive development.展开更多
UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million peopl...UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million people have lost one or both parents due to the AIDS pandemic and 25 million children have been orphaned by HIV/AIDS in 2010. The HIV prevalence in Cameroon is estimated at 5.1%. As of 2010, there were 304,000 deaths due to AIDS in Cameroon. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000 were AIDS orphans. The HIV/AIDS burden impacts child survival, growth and development in the traditional African setting. With so many orphans in the population, along with many vulnerable children, strategies must be developed to respond more effectively to their critical needs. This study provides a model for OVC care and support in Cameroon. The model was developed out of extensive work using a participatory approach involving traditional, administrative and health stakeholders on OVC in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle, Ekondo Titi, and Bafaka-Balue communities in Cameroon. Consultancy services with PLAN Cameroon, the Pan African Institute for Development-West Africa coupled with facilitation of many training workshops on OVC with Save the orphans Foundation, the Ministry of Social Affairs, and the Ministry of Public Health and working with the National AIDS Control Committee. The essential components of a holistic framework for the care of OVC have been identified. A public health model for the care of OVC and a mechanism for their identification and a referral system for testing OVC for HIV are proposed. Through this model, a mechanism for the effective holistic care of OVC and collaboration is enhanced.展开更多
Orphans and Vulnerable Children (OVC) and their families face many challenges but there are opportunities to provide care and support programmes for them in their communities. This paper presents the achievements and ...Orphans and Vulnerable Children (OVC) and their families face many challenges but there are opportunities to provide care and support programmes for them in their communities. This paper presents the achievements and implications of HIV Programme Development Project (HPDP) funded by World Bank on care and support services for OVC in Osun State, Nigeria. Eight Civil Society Organisations (CSOs) were engaged by Osun State Agency for the Control of AIDS (OSACA) as part of HPDP to provide care and support services for OVC between year 2013 and 2015. Using reporting tools, data collected by the CSOs were entered into District Health Information System 2 (DHIS2) platform and analysed using Microsoft Excel. In addition, Key Informant Interviews (KII) were conducted among the selected CSOs, OVC and the caregivers who were beneficiaries of HPDP in Osun State, Nigeria. A total of 12,353 OVC were reached and about half of them were female. There was an increase in the trends of number of OVC seen and the support services provided from the year 2013 to 2015. Of the 12,353 OVC that benefitted from this programme, 1905 (15.4%) received health care services, 5383 (43.6%) received nutritional services, 5317 (43.0%) received educational services and 9861 (79.8%) were provided with psychosocial support services. About 503 (4.1%) of the OVC received economic strengthening services while 270 (2.2%) of household heads were provided with economic support. However, 3 OVC were lost to follow-up, 14 OVC voluntarily withdrew from the project and 6 OVC died. The FGD and KII revealed that the project was very impactful in transforming the lives of the OVC. Programmes for children orphaned and made vulnerable by HIV/AIDS will contribute to the achievement of HIV/ AIDS prevention and control efforts. The HIV/AIDS free generation can be built by responding to the physical, social and mental needs of these children and their families in their communities. There is a need to scale-up this programme.展开更多
The 4th summer camp for AIDS-orphaned children was held in Beijing from August 2-8, 2007. Co-sponsored by the China Youth Concern Commission and China Foundation for the Prevention and Control of STDs （sexually trans...The 4th summer camp for AIDS-orphaned children was held in Beijing from August 2-8, 2007. Co-sponsored by the China Youth Concern Commission and China Foundation for the Prevention and Control of STDs （sexually transmitted disease） and AIDS, the event was attended by 80 AIDS-orphaned children aged 8- 16 from 18 counties and cities of 8 provinces of Shanxi, Yunnan, Henan, Jilin, Liaoning, Guizhou, Sichuan and Anhui.展开更多
At 26, Li Dan could have a promising career as an astronomy major at Beijing Normal University for undergraduate studies and a solar physics major at the National Astronomical Observatory under the Chinese Academy of ...At 26, Li Dan could have a promising career as an astronomy major at Beijing Normal University for undergraduate studies and a solar physics major at the National Astronomical Observatory under the Chinese Academy of Sciences for graduate studies. Few people would anticipate that the young man with such a strong science background would give up science to devote himself completely to children orphaned by AIDS.展开更多
History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use...History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.展开更多
Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what consti...Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.展开更多
In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional ...In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional recovery among severely malnourished HIV/AIDS uninfected and infected children. This was a retrospective cohort study conducted from data of 521 hospitalized severely malnourished children. We used Pearson’s Chi square test to compare proportions;and Student’s independent t-test to compare means;general linear model to analyze repeated measurements. We used mortality relative risk with confidence interval (CI 95%), Kaplan-Meir survival curves and Cox proportional hazard models to analyze the HIV impact on mortality rate. Case fatality rate differed significantly from SAM HIV uninfected (10.7%) and HIV infected children (39.7%), p < 0.001. Mortality relative risk was 3.71, 95% IC [2.51 - 5.47] for HIV infected children. Kaplan-Meir survival curves differed significantly between the two groups, (p Log Rank < 0.001). Cox regression adjusted mortality relative risk of HIV infected children was 4.27, CI: 2.55 - 7.15, p < 0.001. Mean weight gain differed significantly among infected children, p < 0.001. Anthropometric Z-scores means evolution differed significantly between HIV infected and uninfected children and within each group’s subjects for WHZ (p < 0.001) and WAZ (p < 0.001). Mortality relative risk was 3.71 times higher for HIV infected children. Multiples infections and metabolic complications have synergism on death occurrence in sever acute malnutrition;when associated to HIV infection, case fatality rate increases many times. Weight gain and anthropometrics index evolution were very slow for SAM HIV infected children, and specific diet may be needed for more nutritional recovery. Effective interventions, updated and adapting to local country context, to improve survival of severely malnourished HIV/AIDS infected children in HIV and SAM prevalent settings are urgently needed in the area of SAM’s community-based treatment approach.展开更多
Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associat...Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4;95% CI: 1.08 - 10.66, P Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.展开更多
Background: The problem of street children is becoming a world crosscutting issue since these children exist in every part of the world and become a worldwide problem. Objective: To assess factors associated with vuln...Background: The problem of street children is becoming a world crosscutting issue since these children exist in every part of the world and become a worldwide problem. Objective: To assess factors associated with vulnerability to STIs and HIV/AIDS among street children in selected towns of Ethiopia. Methodology: Community-based cross-sectional descriptive study design was used on the three selected towns of Ethiopia from June-September, 2016. A total of 360 street children were selected, using snow ball sampling technique. Data were collected using pre-tested interviewer-administered questionnaire. Logistic regression was used to analyze the data. Results: A total of 360 (97.8%) respondents were included in this study. Among them, 167 (46.4%) of them had practiced sexual intercourse and out of these, 137 (82%) had started having sex at the age of 16 years old. Out of these, 61 (36.53%) of them started to get daily basic needs whereas 54 (32.3%) of them were forcefully raped on the street. Only 53 (59.6%) had used condom consistently and 83 (49.7%) had conducted survival sex within the last 12 months. Children on the street or chewing khat or consumption of alcohol had more vulnerability to STIs and HIV about 2.532 (1.57 - 4.08), 2.32 (1.11 - 4.80), 4.18 (2.31 - 7.55) times respectively. But those enrolled in school were about 0.40 (0.25, 0.64) less likely vulnerable than their counterparts. Conclusion: Street children are at a higher likelihood of vulnerability to STIs and HIV. Intervention targeted multilevel approach such as re-integration with their family, life skills training, sexuality education, creating income-generating activities and information education about STIs and HIV should be considered.展开更多
Background:The purpose of this study was to understand the strategies employed by families that adopt Acquired Immune Deficiency Syndrome(AIDS)-orphaned children(Adoptive families)for coping with and mitigating the im...Background:The purpose of this study was to understand the strategies employed by families that adopt Acquired Immune Deficiency Syndrome(AIDS)-orphaned children(Adoptive families)for coping with and mitigating the impact of AIDS in Mbeya Rural District,Tanzania.High numbers of AIDS-orphaned children aged below 18 years in Mbeya Region have led to increasing the burden of families caring for them.Understanding the coping strategies and impact mitigation activities employed by adoptive families is important in order to develop programmes to help them.Methods:This study employed a qualitative method for data collection(one-on-one in-depth interviews).The respondents included 12 male and 8 female heads of families that provide essential care for AIDS-orphaned children in Mbeya Rural District in Tanzania.The framework approach was used to analyse the data that were collected from 15 July to 15 August 2010.Results:The study findings revealed that adoptive families faced several challenges including financial constraints due to increased needs for basic essentials such as health care expenses,school fees and food.Further impacts on adoptive families included shortage of work opportunities and limited time to address these challenges.To mitigate these challenges,adoptive families employed a range of coping strategies including selling family assets and renting out parts of cultivable land for extra cash.Task reallocation which involved the AIDS-orphaned children entering the labour force was also employed as a strategy to mitigate challenges and involved de-enrolling of children from schools so they could take part in income-generating activities in order to earn supplementary family income.The creation of additional income-generating activities such as poultry farming were other coping mechanisms employed,and these received support from both non-governmental organisations(NGOs)and governmental organisations,including the Isangati Agricultural Development Organization(local NGO)and the local government respectively.Conclusions:The current study identified challenges that adoptive families as well as the AIDS-orphaned children themselves faced in Mbeya Rural District,Tanzania.Recognition of these issues highlights the need for targeted interventions to address the underlying social determinants of human immunodeficiency virus or HIV and AIDS in affected populations in order to prevent further imposition of social,cultural and economic disadvantages on families that provide care for AIDS-orphaned children and the children themselves.These findings may prove useful in provoking discussions that may lead to HIV/AIDS prevention and the development of broader mitigation strategies to alleviate the impact of this scourge on families and communities in rural Tanzania,and in similar settings across the world.展开更多
文摘The Human Immunodeficiency Virus and the resultant disease—Acquired Immune Deficiency Syndrome are global epidemics in recent times. Although the effects of the epidemic have been curtailed somewhat in the developed world, it is not so in developing countries. As such it affects not only the infected but those directly dependent on them. Some of the affected people have been identified as children, who turn out to be unprepared for and defenceless against the imminent hardship prevalent as a consequence of the disease. The effects of the epidemic are felt more in the developing world than in developed countries and this is because the attitude of the developed world to the epidemic is positive, enhanced by awareness of the disease;whereas in the developing countries, a lot of myths are attached to it, affecting the requisite attitude needed to combat the epidemic and its effects. This paper seeks to examine the effects of this epidemic on children in Nigeria, comparing the effects on children in other African countries. The paper also looks at structures in place to cater for these children, and then seeks to proffer improved means of protecting their rights.
文摘This study aimed to research the living status and support system of children orphaned by AIDS in rural Henan Province. The approach of face-to-face questionnaires research was used to assess 501 children’s current situation while in-depth interview was conducted for the support system research. The age range of the children orphaned by AIDS was 2 - 15 years old and the mean age was 11.10 years. Most children among 2 - 6 years had communication skills with temper control and psychological problems. Children of 7 - 15 years old had the ability to take care of themselves and family members but could not do self-regulation. The support system for children orphaned by AIDS included social support, policies support, education support, and health care support but improvement are needed in the future. Support system can be improved through much more feasible and concrete policies and strategies to guarantee these children’s basic needs and comprehensive development.
文摘UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million people have lost one or both parents due to the AIDS pandemic and 25 million children have been orphaned by HIV/AIDS in 2010. The HIV prevalence in Cameroon is estimated at 5.1%. As of 2010, there were 304,000 deaths due to AIDS in Cameroon. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000 were AIDS orphans. The HIV/AIDS burden impacts child survival, growth and development in the traditional African setting. With so many orphans in the population, along with many vulnerable children, strategies must be developed to respond more effectively to their critical needs. This study provides a model for OVC care and support in Cameroon. The model was developed out of extensive work using a participatory approach involving traditional, administrative and health stakeholders on OVC in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle, Ekondo Titi, and Bafaka-Balue communities in Cameroon. Consultancy services with PLAN Cameroon, the Pan African Institute for Development-West Africa coupled with facilitation of many training workshops on OVC with Save the orphans Foundation, the Ministry of Social Affairs, and the Ministry of Public Health and working with the National AIDS Control Committee. The essential components of a holistic framework for the care of OVC have been identified. A public health model for the care of OVC and a mechanism for their identification and a referral system for testing OVC for HIV are proposed. Through this model, a mechanism for the effective holistic care of OVC and collaboration is enhanced.
文摘Orphans and Vulnerable Children (OVC) and their families face many challenges but there are opportunities to provide care and support programmes for them in their communities. This paper presents the achievements and implications of HIV Programme Development Project (HPDP) funded by World Bank on care and support services for OVC in Osun State, Nigeria. Eight Civil Society Organisations (CSOs) were engaged by Osun State Agency for the Control of AIDS (OSACA) as part of HPDP to provide care and support services for OVC between year 2013 and 2015. Using reporting tools, data collected by the CSOs were entered into District Health Information System 2 (DHIS2) platform and analysed using Microsoft Excel. In addition, Key Informant Interviews (KII) were conducted among the selected CSOs, OVC and the caregivers who were beneficiaries of HPDP in Osun State, Nigeria. A total of 12,353 OVC were reached and about half of them were female. There was an increase in the trends of number of OVC seen and the support services provided from the year 2013 to 2015. Of the 12,353 OVC that benefitted from this programme, 1905 (15.4%) received health care services, 5383 (43.6%) received nutritional services, 5317 (43.0%) received educational services and 9861 (79.8%) were provided with psychosocial support services. About 503 (4.1%) of the OVC received economic strengthening services while 270 (2.2%) of household heads were provided with economic support. However, 3 OVC were lost to follow-up, 14 OVC voluntarily withdrew from the project and 6 OVC died. The FGD and KII revealed that the project was very impactful in transforming the lives of the OVC. Programmes for children orphaned and made vulnerable by HIV/AIDS will contribute to the achievement of HIV/ AIDS prevention and control efforts. The HIV/AIDS free generation can be built by responding to the physical, social and mental needs of these children and their families in their communities. There is a need to scale-up this programme.
文摘The 4th summer camp for AIDS-orphaned children was held in Beijing from August 2-8, 2007. Co-sponsored by the China Youth Concern Commission and China Foundation for the Prevention and Control of STDs （sexually transmitted disease） and AIDS, the event was attended by 80 AIDS-orphaned children aged 8- 16 from 18 counties and cities of 8 provinces of Shanxi, Yunnan, Henan, Jilin, Liaoning, Guizhou, Sichuan and Anhui.
文摘At 26, Li Dan could have a promising career as an astronomy major at Beijing Normal University for undergraduate studies and a solar physics major at the National Astronomical Observatory under the Chinese Academy of Sciences for graduate studies. Few people would anticipate that the young man with such a strong science background would give up science to devote himself completely to children orphaned by AIDS.
文摘History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.
文摘Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.
文摘In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional recovery among severely malnourished HIV/AIDS uninfected and infected children. This was a retrospective cohort study conducted from data of 521 hospitalized severely malnourished children. We used Pearson’s Chi square test to compare proportions;and Student’s independent t-test to compare means;general linear model to analyze repeated measurements. We used mortality relative risk with confidence interval (CI 95%), Kaplan-Meir survival curves and Cox proportional hazard models to analyze the HIV impact on mortality rate. Case fatality rate differed significantly from SAM HIV uninfected (10.7%) and HIV infected children (39.7%), p < 0.001. Mortality relative risk was 3.71, 95% IC [2.51 - 5.47] for HIV infected children. Kaplan-Meir survival curves differed significantly between the two groups, (p Log Rank < 0.001). Cox regression adjusted mortality relative risk of HIV infected children was 4.27, CI: 2.55 - 7.15, p < 0.001. Mean weight gain differed significantly among infected children, p < 0.001. Anthropometric Z-scores means evolution differed significantly between HIV infected and uninfected children and within each group’s subjects for WHZ (p < 0.001) and WAZ (p < 0.001). Mortality relative risk was 3.71 times higher for HIV infected children. Multiples infections and metabolic complications have synergism on death occurrence in sever acute malnutrition;when associated to HIV infection, case fatality rate increases many times. Weight gain and anthropometrics index evolution were very slow for SAM HIV infected children, and specific diet may be needed for more nutritional recovery. Effective interventions, updated and adapting to local country context, to improve survival of severely malnourished HIV/AIDS infected children in HIV and SAM prevalent settings are urgently needed in the area of SAM’s community-based treatment approach.
文摘Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4;95% CI: 1.08 - 10.66, P Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.
文摘Background: The problem of street children is becoming a world crosscutting issue since these children exist in every part of the world and become a worldwide problem. Objective: To assess factors associated with vulnerability to STIs and HIV/AIDS among street children in selected towns of Ethiopia. Methodology: Community-based cross-sectional descriptive study design was used on the three selected towns of Ethiopia from June-September, 2016. A total of 360 street children were selected, using snow ball sampling technique. Data were collected using pre-tested interviewer-administered questionnaire. Logistic regression was used to analyze the data. Results: A total of 360 (97.8%) respondents were included in this study. Among them, 167 (46.4%) of them had practiced sexual intercourse and out of these, 137 (82%) had started having sex at the age of 16 years old. Out of these, 61 (36.53%) of them started to get daily basic needs whereas 54 (32.3%) of them were forcefully raped on the street. Only 53 (59.6%) had used condom consistently and 83 (49.7%) had conducted survival sex within the last 12 months. Children on the street or chewing khat or consumption of alcohol had more vulnerability to STIs and HIV about 2.532 (1.57 - 4.08), 2.32 (1.11 - 4.80), 4.18 (2.31 - 7.55) times respectively. But those enrolled in school were about 0.40 (0.25, 0.64) less likely vulnerable than their counterparts. Conclusion: Street children are at a higher likelihood of vulnerability to STIs and HIV. Intervention targeted multilevel approach such as re-integration with their family, life skills training, sexuality education, creating income-generating activities and information education about STIs and HIV should be considered.
文摘Background:The purpose of this study was to understand the strategies employed by families that adopt Acquired Immune Deficiency Syndrome(AIDS)-orphaned children(Adoptive families)for coping with and mitigating the impact of AIDS in Mbeya Rural District,Tanzania.High numbers of AIDS-orphaned children aged below 18 years in Mbeya Region have led to increasing the burden of families caring for them.Understanding the coping strategies and impact mitigation activities employed by adoptive families is important in order to develop programmes to help them.Methods:This study employed a qualitative method for data collection(one-on-one in-depth interviews).The respondents included 12 male and 8 female heads of families that provide essential care for AIDS-orphaned children in Mbeya Rural District in Tanzania.The framework approach was used to analyse the data that were collected from 15 July to 15 August 2010.Results:The study findings revealed that adoptive families faced several challenges including financial constraints due to increased needs for basic essentials such as health care expenses,school fees and food.Further impacts on adoptive families included shortage of work opportunities and limited time to address these challenges.To mitigate these challenges,adoptive families employed a range of coping strategies including selling family assets and renting out parts of cultivable land for extra cash.Task reallocation which involved the AIDS-orphaned children entering the labour force was also employed as a strategy to mitigate challenges and involved de-enrolling of children from schools so they could take part in income-generating activities in order to earn supplementary family income.The creation of additional income-generating activities such as poultry farming were other coping mechanisms employed,and these received support from both non-governmental organisations(NGOs)and governmental organisations,including the Isangati Agricultural Development Organization(local NGO)and the local government respectively.Conclusions:The current study identified challenges that adoptive families as well as the AIDS-orphaned children themselves faced in Mbeya Rural District,Tanzania.Recognition of these issues highlights the need for targeted interventions to address the underlying social determinants of human immunodeficiency virus or HIV and AIDS in affected populations in order to prevent further imposition of social,cultural and economic disadvantages on families that provide care for AIDS-orphaned children and the children themselves.These findings may prove useful in provoking discussions that may lead to HIV/AIDS prevention and the development of broader mitigation strategies to alleviate the impact of this scourge on families and communities in rural Tanzania,and in similar settings across the world.
