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) |