The Prevalence and Factors Associated with Unsuppressed Viral Loads Among Adolescents Attending HIV Clinic in Kiryandongo Hospital, Kiryandongo District, Uganda

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TABLE OF CONTENTS


DECLARATION .....................................................................................................................................i

APPROVAL..........................................................................................................................................ii

DEDICATION......................................................................................................................................iii

ACKNOWLEDGEMENT........................................................................................................................ iv

TABLE OF CONTENTS .......................................................................................................................... v

LIST OF FIGURES ............................................................................................................................... vii

DEFINITION OF TERMS..................................................................................................................... viii

LIST OF ABBREVIATIONS..................................................................................................................... ix

ABSTRACT.......................................................................................................................................... x

CHAPTER ONE .................................................................................................................................... 1

INTRODUCTION.................................................................................................................................. 1

1.0 Study Background ..................................................................................................................... 1

1.1 Theoretical Perspective ............................................................................................................. 2

1.2 Conceptual Perspective ............................................................................................................. 2

1.3 Contextual Perspective.............................................................................................................. 3

1.4 Problem Statement................................................................................................................... 3

1.5 General Objective...................................................................................................................... 3

1.5.1 Specific Objectives.................................................................................................................. 3

1.6 Research Questions................................................................................................................... 3

1.7 Significance of the Study............................................................................................................ 3

1.8 Conceptual Framework.............................................................................................................. 4

1.9 Scope of Study .......................................................................................................................... 4

CHAPTER TWO ................................................................................................................................... 6

LITERATURE REVIEW........................................................................................................................... 6

2.0 Introduction.............................................................................................................................. 6

2.1 HIV Virological Failure................................................................................................................ 6

2.1.1 Patient Adherence-Related Factors:.................................................................................. 6

2.1.2 HIV-Related Factors......................................................................................................... 6

vi

2.1.3 ARV Regime-Related Factors ........................................................................................... 7

2.2 Adherence to Anti- Retro Viral Drugs.......................................................................................... 7

2.2.1 Barriers to Nonadherence to ART..................................................................................... 7

2.2.2 Facilitators to Help Improve ARV Adherence................................................................... 8

2.3 Disclosure of HIV Status............................................................................................................. 9

2.3.1 Barriers to Disclosure of HIV Status................................................................................. 9

2.3.2 Facilitators to Disclosure of HIV Status .......................................................................... 10

2.4 Conclusions from Literature ..................................................................................................... 10

CHAPTER THREE ............................................................................................................................... 11

STUDY METHODOLOGY..................................................................................................................... 11

3.0 Introduction............................................................................................................................ 11

3.1 Research Design...................................................................................................................... 11

3.2 Study Area.............................................................................................................................. 11

3.3 Study Population..................................................................................................................... 11

3.4 Sample Size............................................................................................................................. 11

3.5 Sampling Method.................................................................................................................... 12

3.6 Data Collection........................................................................................................................ 12

3.7 Data Collection Procedures...................................................................................................... 12

3.8 Data Analysis and Presentation................................................................................................ 12

3.9 Ethical Considerations............................................................................................................. 12

3.10 Limitations of Study............................................................................................................... 12

CHAPTER FOUR................................................................................................................................. 13

RESULTS OF THE STUDY .................................................................................................................... 13

4.0 Introduction............................................................................................................................ 13

4.1 Socio-demographic Characteristics of Respondents................................................................... 13

4.2 Viral Load Suppression............................................................................................................. 14

4.3 Reasons for Failed Viral Load Suppression................................................................................. 16

CHAPTER FIVE .................................................................................................................................. 18

DISCUSSION OF RESULTS................................................................................................................... 18

5.0 Introduction............................................................................................................................ 18

5.1 Socio-demographic Characteristics........................................................................................... 18

5.2 Viral Load Suppression............................................................................................................. 18

5.3 Reasons for Failed Viral Load Suppression................................................................................. 19

vii

CHAPTER SIX .................................................................................................................................... 21

CONCLUSION AND RECOMMENDATIONS........................................................................................... 21

6.0 Introduction............................................................................................................................ 21

6.1 Conclusions............................................................................................................................. 21

6.2 Recommendations.................................................................................................................. 21

REFERENCES................................................................................................................................. 23

APPENDICES..................................................................................................................................... 25

Appendix I: Introductory Letter...................................................................................................... 25

Appendix II: Questionnaire ............................................................................................................ 26

Appendix III: Map of Uganda Showing the Location of Kiryandongo ................................................. 27

Appendix IV: Map of Kiryandongo and the Neighboring Regions..................................................... 28

Appendix V: Research Work Plan 2017/2018 .................................................................................. 29

Appendix VI: Research Budget....................................................................................................... 30

ABSTRACT 
Introduction There is a growing recognition that adolescents are a key population in need of attention within the worldwide HIV/ AIDS response. Globally, about 2.1 million adolescents between ages 10 and 19 years are living with HIV. In 2014, there were approximately 220,000 new HIV infections among adolescents aged between 15 to 19 years. This study was done at Kiryandongo hospital HIV Clinic. Objectives The objective was to determine the prevalence of HIV positive adolescents and the factors associated with unsuppressed viral loads among HIV positive adolescents attending HIV clinic at Kiryandongo hospital HIV Clinic from August 2014 to December 2017. Methodology The sampling was by getting hospital records from the HIV Care/ART card for HIV positive adolescents and interviews with health workers with experience and in-depth knowledge on HIV Care in adolescents receiving ART care at the hospital. Results Most of the records show the adolescents attending ART clinic at Kiryandongo General Hospital were within a range of 10 to 13 years (62.5%), and the remaining 37.5% were between 14-19 years and up to 95% of the respondents had some form of formal education levels. Up to 67% of the respondents had their viral load suppressed from treatment with ART while the remaining 33% had unsuppressed viral load. Of the 33% with unsuppressed viral load, 12.5% had their viral load suppressed after Intensive Adherence Counseling of 3 months while the 20.5% had no viral load suppression even after IAC. The unsuppressed viral load was attributable to non-adherence (25.4%) even after 3 months of IAC and 10.2% due to treatment failure and up to 28% did not change treatment to the second line and only 5% had changed treatment to the second line. Up to 50% of the respondents had failed viral load suppression due to non-adherence to ART. Another 30% was due to non-disclosure by the care taker and 15% did not have anyone to remind them to take their ARVs while 5% had no care takers. Conclusion xi This study shows that participants to the study were in early teen years and up to 95% of the respondents had some form of formal education levels. Two thirds of respondents had viral load suppressed from treatment with ART while the remaining a third had unsuppressed viral load. About 12.5% had their viral load suppressed after Intensive Adherence Counseling of 3 months while 20.5% had no viral load suppression even after IAC. The unsuppressed viral load was attributable to non-adherence even after 3 months of IAC and treatment failure. Up to 28% did not change treatment to the second line and only 5% had changed treatment. Factors contributing to non-adherence were lack of reminders and no care takers. Recommendations The following recommendations are suggested; parents/guardians should accompany their children during refills, should ensure that the HIV sero-status of such children are disclosed to them as early as possible. Parents/guardians should ensure that they disclose the sero-status of such children to another caring close family member. The hospital HIV health providers, counselors and community volunteers should engage the parents/guardians and the children in FGDs, identify their problems and challenges and try to find and or address these problems or challenges. Parents/guardians should be counseled and sensitized about good nutrition and the side effects of ART.

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APA

CHRISTINE, M (2022). The Prevalence and Factors Associated with Unsuppressed Viral Loads Among Adolescents Attending HIV Clinic in Kiryandongo Hospital, Kiryandongo District, Uganda. Afribary. Retrieved from https://afribary.com/works/the-prevalence-and-factors-associated-with-unsuppressed-viral-loads-among-adolescents-attending-hiv-clinic-in-kiryandongo-hospital-kiryandongo-district-uganda

MLA 8th

CHRISTINE, MULOWOZA "The Prevalence and Factors Associated with Unsuppressed Viral Loads Among Adolescents Attending HIV Clinic in Kiryandongo Hospital, Kiryandongo District, Uganda" Afribary. Afribary, 18 Jul. 2022, https://afribary.com/works/the-prevalence-and-factors-associated-with-unsuppressed-viral-loads-among-adolescents-attending-hiv-clinic-in-kiryandongo-hospital-kiryandongo-district-uganda. Accessed 09 Aug. 2022.

MLA7

CHRISTINE, MULOWOZA . "The Prevalence and Factors Associated with Unsuppressed Viral Loads Among Adolescents Attending HIV Clinic in Kiryandongo Hospital, Kiryandongo District, Uganda". Afribary, Afribary, 18 Jul. 2022. Web. 09 Aug. 2022. < https://afribary.com/works/the-prevalence-and-factors-associated-with-unsuppressed-viral-loads-among-adolescents-attending-hiv-clinic-in-kiryandongo-hospital-kiryandongo-district-uganda >.

Chicago

CHRISTINE, MULOWOZA . "The Prevalence and Factors Associated with Unsuppressed Viral Loads Among Adolescents Attending HIV Clinic in Kiryandongo Hospital, Kiryandongo District, Uganda" Afribary (2022). Accessed August 09, 2022. https://afribary.com/works/the-prevalence-and-factors-associated-with-unsuppressed-viral-loads-among-adolescents-attending-hiv-clinic-in-kiryandongo-hospital-kiryandongo-district-uganda