ArticleAIDS research and treatment2012
Barriers to Initiation of Pediatric HIV Treatment in Uganda: A Mixed-Method Study.
Article in AIDS research and treatment, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- How informal healthcare providers improve uptake of HIV testing: qualitative results from a randomized controlled trial.AIDS (London, England) · 2022Trial
- Trial
- Barriers to HIV care in Uganda and implications for universal test-and-treat: a qualitative study.AIDS care · 2022Article
- Exploring perceived effects from loss of PEPFAR support for outreach in Kenya and Uganda.Globalization and health · 2021Article
- Attendance of psychosocial teen clubs and self-reported antiretroviral medication adherence: a cross section study of adolescents with perinatal HIV in the Kingdom of Lesotho.AIMS public health · 2021Article
- Cost analysis and provider preferences of low-dose, high-frequency approach to in-service training programs in Uganda.Journal of global health · 2019Article
- Late antiretroviral therapy initiation and associated factors among children on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia: a cross-sectional study.BMC research notes · 2019Article
- First-line HIV treatment failures in non-B subtypes and recombinants: a cross-sectional analysis of multiple populations in Uganda.AIDS research and therapy · 2019Article
- Article
- Absence of HIV-1 Drug Resistance Mutations Supports the Use of Dolutegravir in Uganda.AIDS research and human retroviruses · 2018Article
- Scaling up Pediatric HIV Testing by Incorporating Provider-Initiated HIV Testing Into all Child Health Services in Hurungwe District, Zimbabwe.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland.African journal of AIDS research : AJAR · 2017Article
- HIV Drug Resistance Among Children Initiating First-Line Antiretroviral Treatment in Uganda.AIDS research and human retroviruses · 2016Observational
- Non-Uptake of HIV Testing in Children at Risk in Two Urban and Rural Settings in Zambia: A Mixed-Methods Study.PloS one · 2016Article
- Disclosure, stigma of HIV positive child and access to early infant diagnosis in the rural communities of OR Tambo District, South Africa: a qualitative exploration of maternal perspective.BMC pediatrics · 2015Article
- High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs.BMC pediatrics · 2015Article
- The burden of disease on HIV-infected orphaned and non-orphaned children accessing primary health facilities in a rural district with poor resources in South Africa: a cross-sectional survey of primary caregivers of HIV-infected children aged 5-18 years.Infectious diseases of poverty · 2015Article
- Access to HIV prevention and care for HIV-exposed and HIV-infected children: a qualitative study in rural and urban Mozambique.BMC public health · 2014Article
- Pre-ART retention in care and prevalence of tuberculosis among HIV-infected children at a district hospital in southern Ethiopia.BMC pediatrics · 2014Article
- Follow-up of infants diagnosed with HIV - Early Infant Diagnosis Program, Francistown, Botswana, 2005-2012.MMWR. Morbidity and mortality weekly report · 2014Article
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Authors and funding
14 authors.
Funding
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Abstract
Although the advantages of early infant HIV diagnosis and treatment initiation are well established, children often present late to HIV programs in resource-limited settings. We aimed to assess factors related to the timing of treatment initiation among HIV-infected children attending three clinical sites in Uganda. Clinical and demographic determinants associated with early disease (WHO clinical stages 1-2) or late disease (stages 3-4) stage at presentation were assessed using multilevel logistic regression. Additionally, semistructured interviews with caregivers and health workers were conducted to qualitatively explore determinants of late disease stage at presentation. Of 306 children initiating first-line regimens, 72% presented late. Risk factors for late presentation were age below 2 years old (OR 2.83, P = 0.014), living without parents (OR 3.93, P = 0.002), unemployment of the caregiver (OR 4.26, P = 0.001), lack of perinatal HIV prophylaxis (OR 5.66, P = 0.028), and high transportation costs to the clinic (OR 2.51, P = 0.072). Forty-nine interviews were conducted, confirming the identified risk factors and additionally pointing to inconsistent referral from perinatal care, caregivers' unawareness of HIV symptoms, fear, and stigma as important barriers. The problem of late disease at presentation requires a multifactorial approach, addressing both health system and individual-level factors.
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