11 research outputs found
Disclosure of HIV Status to Adolescents Aged 10-15 Years Living with HIV in Kafue District of Lusaka Province in Zambia
No full textBackground: Disclosure of HIV status by caregivers to adolescents is low. This
affects access to HIV care and treatment by adolescents living with HIV. While
studies have been done to understand disclosure patterns, limited knowledge exists on
factors that facilitate and inhibit disclosure by caregivers to adolescents aged between
10 to 15 years in Kafue district. This study explored factors related to caregiver
disclosure of HIV-positive status to adolescents under their care.
Methods: This was an exploratory health facility-based qualitative study. Data was
collected through in-depth interviews with 30 caregivers of adolescents living with
HIV and health care providers. Data was coded using NVIVO and analysed using
latent content analysis approach.
Results: 17 out of 30 caregivers had informed the adolescents about their HIV status.
Reasons for disclosing the HIV status included inquiries by adolescents about reasons
for taking of medication, threats by adolescents not to take HIV medication, desire to
promote treatment self-efficacy amongst adolescents, maintaining/sustaining future
cordial relationships as well as facilitating adoption of safe sexual behaviour. Direct
conversations between caregivers and adolescents as well as assisted disclosure at the
health facility were the two strategies used. Factors that facilitated HIV disclosure
were adolescents ‘knowledge of HIV and caregiver’s knowledge of and experience
with HIV programs. Factors that inhibited disclosure of HIV status included fear of
psychological trauma by adolescents, perceived inability of adolescents to keep their
HIV status confidential which could attract HIV stigmatisation for the family, and
caregivers’ fear of being blamed by the adolescents for the infection.
Conclusions: There is a need to improve disclosure skills of caregivers, promote
assisted disclosure and establish adolescent-specific clinic days. Caregiver disclosure
of their own HIV status is also crucial to ensure acceptance of HIV status by
adolescents while efforts to address HIV stigma are still warranted
Disclosure of HIV status to Adolescents aged 10-15 years living with HIV in Kafue District of Lusaka Province in Zambia
No full textBackground: Disclosure of HIV status by caregivers to adolescents is low. This affects access to HIV care and treatment by adolescents living with HIV. While studies have been done to understand disclosure patterns, limited knowledge exists on factors that facilitate and inhibit disclosure by caregivers to adolescents aged between 10 to 15 years in Kafue district. This study explored factors related to caregiver disclosure of HIV-positive status to adolescents under their care.Methods: This was an exploratory health facility-based qualitative study. Data was collected through in-depth interviews with 30 caregivers of adolescents living with HIV and health care providers. Data was coded using NVIVO and analysed using latent content analysis approach.Results: 17 out of 30 caregivers had informed the adolescents about their HIV status. Reasons for disclosing the HIV status included inquiries by adolescents about reasons for taking of medication, threats by adolescents not to take HIV medication, desire to promote treatment self-efficacy amongst adolescents,maintaining/sustaining future cordial relationships as well as facilitating adoption of safe sexual behaviour. Direct conversations between caregivers and adolescents as well as assisted disclosure at the health facility were the two strategies used. Factors that facilitated HIV disclosure were adolescents ‘knowledge of HIV and caregiver’s knowledge of and experience with HIV programs. Factors that inhibited disclosure of HIV status included fear of psychological trauma by adolescents, perceived inability of adolescents to keep their HIV status confidential which could attract HIV stigmatisation for the family, and caregivers’ fear of being blamed by the adolescents for the infection.
Conclusions: There is a need to improve disclosure skills of caregivers, promote assisted disclosure and establish adolescent-specific clinic days. Caregiver disclosure of their own HIV status is also crucial to ensure acceptance of HIV status by adolescents while efforts to address HIV stigma are still warranted
“When am I going to stop taking the drug?” Enablers, barriers and processes of disclosure of HIV status by caregivers to adolescents in a rural district in Zambia
No full textBackground: Disclosure of adolescents\u27 own HIV status by caregivers is not only challenging but low. The reasons for this remain unclear despite efforts to examine and seek to understand disclosure patterns or factors that may either facilitate or inhibit this disclosure. This study explored the enablers, barriers and processes of disclosure of HIV status to adolescents by their caregivers in Kafue district of Zambia. Methods: A case study method was used to understand factors that facilitate or inhibit caregiver\u27s ability to disclose the HIV status of adolescents aged 10-15 years. Data collected through in-depth interviews with 30 caregivers as well as 6 key informants were analysed using thematic analysis. Results: Overall, 17 out of 30 (56.7 %) caregivers had informed the adolescents about their HIV status. Reasons for disclosing of the HIV status included inquiries by adolescents as to why they were taking medication, threats by adolescents not to take HIV medication, desire to promote treatment self-efficacy amongst adolescents as well as facilitating adoption of safe sexual behaviour among adolescents. The disclosure processes were conducted either at the home or at the clinic. Enabling factors for HIV disclosure were adolescents\u27 knowledge of HIV and caregivers\u27 knowledge of and experience with HIV programs. Barriers to disclosure of HIV status included fear of psychological trauma for the adolescents, perceived inability of adolescents to keep their HIV status confidential which could attract HIV stigmatisation for the family, and caregivers\u27, fear of being blamed by the adolescents for the infection, limited disclosure skills by caregivers as well as negative attitude by some HIV counsellors. Conclusions: Despite challenges associated with disclosure of adolescents\u27 own HIV status by caregivers, environments that facilitate this process exist and can be strengthened. Promoting HIV disclosure requires in-depth and context-specific understanding of the factors that enable and undermine this process. Limitations in this understanding may have played critical roles in past strategic implementation of locally driven and relevant interventions to improve disclosure of HIV status by caregivers to adolescents in Zambia
Vaccines and Immunostimulants for Finfish
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
Data for: Support or control? Qualitative interviews with Zambian women on male partner involvement in HIV care during and after pregnancy
No full textProject Summary
The goal of this qualitative study was to generate a better understanding of relationship processes with male partners that affect women’s prevention of mother-to-child HIV transmission (PMTCT)-related health behaviours through a critical examination of gender and power. This study was part of a larger concurrent mixed-methods parent study on the relationship between gender power dynamics within heterosexual couples and women’s PMTCT adherence. From March to August 2014, a cross-sectional survey was administered to 320 postpartum women living with HIV attending well-child paediatric healthcare visits at a large public health centre within a densely populated, low socio-economic neighbourhood of Lusaka. A convenience sub-sample of 32 participants in the parent study was invited to also participate in a semi-structured qualitative interview. The goal of the interviews was to expand on and explain the quantitative survey findings regarding the relationship between gender power dynamics and PMTCT-related health behaviours.
Data Overview
Participants were recruited during routine paediatric healthcare visits (e.g., child immunisations, height and weight measurements). Women were eligible for participation if they were married or cohabiting with a male partner, HIV-positive, over 18 years of age (legal age to provide consent for research in Zambia), and had a biological child between 3 to 9 months of age. Infant age criteria were meant to capture the essential PMTCT protocols, match the paediatric immunisation schedule, and limit recall bias. Because a major focus of the parent study was on intimate partner violence (IPV), as a safety measure, we excluded any women who were at the clinic with their male partners; only one woman was excluded for this reason. Nurses at the clinic determined eligibility for the parent study using the child’s “Under-Five Card” (i.e., a mother’s copy of her child’s health record that she is required to bring to all healthcare visits) or other available medical records. Eligible women were consented by research staff and received a small travel reimbursement.
All survey participants were invited to stay and participate in a semi-structured interview immediately after the survey on the same day in the same location. Interviews were conducted by experienced, trained local Zambian research assistants in the most commonly spoken languages (English, Nyanja, Bemba, Tonga) using a semi-structured interview guide. The interview guide included broad, open-ended questions regarding PMTCT experiences and gender power dynamics. All research assistants had qualitative public health experience and participated in a three-day training. Data analysis and recruitment occurred concurrently and continued until the research team agreed we had achieved theoretical saturation of themes informing how gender power dynamics affect women’s PMTCT-related health behaviours. Throughout data collection, memos were kept in order to create a rich description of the data and to identify any needed changes to the interview guide, as well as establish theoretical saturation. Interviews were audio-recorded, translated and transcribed verbatim into Microsoft Word, and imported into Atlas.ti for analysis.
The codebook was developed and applied to the transcripts by the primary investigator (Dr. Hampanda) using a combination of a priori codes from the interview guide and emergent codes. The author began with initial, line-by-line coding of transcripts to identify meanings and assumptions within the data, as well as comparisons between the codes and participants. In the final stages of analysis, focused coding by two of the investigators (Dr. Hampanda and Dr. Mweemba) explored the underlying meanings of the participant narratives and how they add to, form, transform, or reflect gendered social structures and processes in relation to women’s HIV care during and after pregnancy. We applied Fairclough’s method of critical discourse analysis, which emphasises how participant narratives are linked to societal and cultural processes and structures. Our critical discourse analysis interrogated the transcripts by paying attention to issues of explicit and implicit gender power dynamics and how participants navigated these in the context of PMTCT care.
A table of excerpts is included with one short excerpt from the interview transcripts for every code used in the qualitative coding. Full transcripts are not shared to conform to assurances made to participants during informed consent. Publicly sharing the full transcripts would violate the agreement to which the participants consented
Vaccines and Immunostimulants for Finfish
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
Authorship and partnerships in health promotion research: issues of erasure, ownership and inequity in knowledge production
No full textEarlier this year, the authors of this editorial submitted a paper to a major international health promotion conference and, after peer review, were accepted and invited to present. The presentation was titled ‘North-South Health Research Partnerships in an Unequal World’ and it presented findings from a qualitative study exploring the experiences of local health research stakeholders in Zambia with international health research collaborations. Because of funding constraints, Corbin (the one Northern partner from a high-income country) was the only author who was able to travel to attend the conference and present on behalf of the team. Because of revenue problems on the part of the conference organizers, they were forced to implement a policy which required that everyone listed in the program pay the ∼$300 USD registration fee (this was the discounted rate for low-income countries). The Zambian partners, lacking funds, were not able to pay even this discounted registration fee. So, while they did appear in the online link to the full text of the conference abstracts, their names were literally erased from their research in the official program
HIV, syphilis and sexual-risk behaviours’ prevalence among in-and out-of-school adolescent girls and young women in Zambia: A cross-sectional survey study
No full textExploring the barriers, facilitators, and opportunities to enhance uptake of sexual and reproductive health, HIV and GBV services among adolescent girls and young women in Zambia : a qualitative study
No full textIntroduction: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia. Methods: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis. Results: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services. Conclusion: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population
Factors influencing the re-engagement of school dropout adolescent girls into the education system following the enactment of the re-entry policy in Zambia : a qualitative study
No full textIntroduction: Globally, adolescent pregnancy and marriage contribute to high school dropout rates. Girls who drop out of school early tend to have poorer health indicators than those who continue their education. In 1997, the government of Zambia, through the Ministry of Education, introduced the Re-entry Policy to facilitate adolescent girls who had dropped out of school to continue their education. However, since this policy enactment, there has not been any formal study to explore the facilitators and challenges of its implementation. This study explored factors influencing the re-engagement of school dropout girls into the education system following the enactment of the Re-entry Policy in Zambia. Methods: This was a qualitative study conducted in three priority districts in Zambia between September and October 2022. We conducted 26 key informant interviews with officials from the district government department, implementing partners, community members, and parent-teacher association representatives, 14 in-depth interviews, and 5 focus-group discussions with girls who re-engaged into the education system and those who had not returned to school. Data were collected on the reasons why girls had dropped out, facilitators of their re-engagement, and challenges experienced during and/or after the re-engagement process. Data analysis was conducted using a reflexive thematic analysis approach, following a structured coding process. Results: Factors influencing girls to drop out of school included socioeconomic constraints, gender roles and inequality, long distances to schools, and inadequate and unsafe boarding facilities. Conversely, factors facilitating girls’ return to school included the recognition of the value of education as a means for achieving personal development, a supportive policy environment, educational sponsorships, the engagement of community and traditional leadership in ending child marriages. However, the challenges for re-engaging girls back to school included limited comprehensive sponsorship and funding opportunities, limited implementing partners funding opportunities for girls to stay in school, and inadequate community awareness of the Re-entry Policy. Suggested strategies to address the challenges that girls face in re-engaging them back to school included an expansion of existing limited school infrastructure and increased implementation of Comprehensive Sexuality Education (CSE) in schools. Conclusion: Socioeconomic, cultural, and structural factors rank among the major challenges that limit girls’ re-entry and retention in the school system. Therefore, increasing resources and opportunities for scholarships, expanding school infrastructure, and engaging stakeholders to improve access to and delivery of quality education are essential measures to enable girls to attain their educational potential. Policy Implications: The findings highlight the need for strengthening existing policies to address socioeconomic constraints, gender inequality, and unsafe boarding to reduce dropout rates. Additionally, increasing educational sponsorship, community awareness of the Re-entry Policy, community leadership, and parents’ involvement in preventing child pregnancies and marriages is essential. Finally, the government should expand the school infrastructure, strengthen the implementation of CSE to facilitate overcoming the current challenges, and support girls’ return to school for social development.Errata: Chavula, M.P., Habib, B., Halwiindi, H. et al. Correction to: Factors Influencing the Re-engagement of School Dropout Adolescent Girls into the Education System Following the Enactment of the Re-entry Policy in Zambia: A Qualitative Study. Sex Res Soc Policy (2025). https://doi.org/10.1007/s13178-025-01144-1</p
