Background:
In 2011, the CALWHA program (Children and Adolescent Living with HIV/AIDS) was developed by the association METIS (Student Movement Working Against Health Access Inequalities). Shirati is a known area to have one of the highest prevalence of HIV in Tanzania and at the world level. It was one of the reasons to implement the program there in 2013.
The goal of the program was to improve the physical and mental well-being, antiretroviral therapy adherence, and retention of care of children and adolescents living with HIV. The evaluation survey conducted in 2016 identified that there was a need to improve education of the program. This is regularly requested by or on behalf of the children, the caretakers and the health professionals. HIV knowledge of the children was also tested during the annual monitoring. There were gaps concerning their understanding of the disease, despite education being an essential objective and component of the project.
Aim:
The objective of this Master thesis was to understand the gaps in HIV-related knowledge among children and adolescents living with HIV/AIDS treated at Shirati KMT CDH, and to identify the best strategy to educate this population on those subjects.
Methods:
We conducted 22 in-depth interviews and 5 focus groups with a convenience and purposeful samples. A total of 56 individuals were interviewed including children and adolescents, caretakers, doctors, nurses, data clerks, pharmacist and home-based caretakers at Shirati KMT CTC clinic and at participants’ home in August 2018.
Interview topics included HIV, different transmission pathways, antiretrovirals (ARVs), health management (pills, food, opportunistic illnesses), pregnancy and mother transmission, HIV stigma, relations and sexuality, adherence, clinical follow-up, peer education and genderbased education.
Transcribed texts were coded and analyzed based on grounded theory.
Results and discussion:
We identified the different gaps of knowledge that should be focused to improve education and address participants’ requests: different HIV transmission pathways, the impact of this virus in the body, the name and the mechanisms of ARVs, opportunistic infections, importance of clinic attendance, disclosure, self-awareness, sexuality, family planning issues, relationships, prevention, pregnancy, motherhood, safe baby delivery, nutrition, life-style, health in general and hygiene.
The best strategy to educate this population would be a visual support. Other ways of providing education such as peer education, community-based education, gender-based education and games are already used at Shirati KMT CDH, they need to be consolidated, especially peer education. An additional day for education must be discussed depending on the available resources.