PUB022 - Publication Only
Parents accessing HIV treatment and care - are they an underutilised pathway of increasing access to HIV care in their infants and children?
K. Mwanda1, C. Zarowsky2
1John Snow Incorporation (JSI)/ Support to HIV Response in Zambia II Project (SHARe II), HIV/AIDS Leadership, Lusaka, Zambia, 2University of the Western Cape, SA, Public Health, Cape Town, South Africa
Background: Most national and
international responses to HIV/AIDS are disproportionately in favour of
adults as compared to children. In 2010, Zambia''s coverage of HIV treatment
among children under the age of 15 years stood at 28.1% while that for the 15
years and older age group was reported as 90.0%. This imbalance and the fact
that 95% of children acquire HIV vertically from their mothers caused us to investigate
the effectiveness of a model that aimed at increasing children''s access to HIV
treatment/care through providing a focused counseling session to their infected parents.
Methods: A randomized interventional cohort study that
enrolled 254 HIV positive adults aged 18 to 49 years and accessing HIV treatment/care
between August and September 2012 at Solwezi Urban Clinic and Solwezi General
Hospitals in North-Western Province of Zambia. Interviewer administered
questionnaires were used to obtain data during two interviews spaced one month apart. The intervention constituted a brief counseling session on the
importance of HIV treatment/care in their children. The
second interview determined whether the respondents had facilitated for
their children to access care as a consequence of the
counseling session. Analysis was based on a comparison between those responds that facilitated for their children to access treatment/ care and those that did not.
Results: The proportion of adults who had their
children tested/enrolled into care increased from 18.9% at inception to 59.4%
at one month post intervention (Chi square 52.025; p< 0.001). Of the 182 adults
who had not yet had their children tested 56.3% (n=103/182) brought their
children to access HIV testing/treatment/care. Disaggregation by gender revealed
63.1% of the women against 33.3% of the men brought their children after having
received the intervention (OR 3.48, p=0.000).
Conclusions: Providing adults with a counseling intervention on the benefits of having
their children tested or entered into care is a viable means of increasing the
uptake of HIV testing, and entry into HIV treatment/care in young children. Such innovations also have potential to
contribute to the attainment of the MDG target of universal access to treatment for HIV/AIDS for all those who
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