Evidence map›Paper›PMID 37747873›Full record

ArticlePLOS global public health2023

Navigating antiretroviral adherence in boarding secondary schools in Nairobi, Kenya: A qualitative study of adolescents living with HIV, their caregivers and school nurses.

Nicholas Kipkurui, Emmah Owidi, James Ayieko, Gerald Owuor, Irene Mugenya, Kawango Agot, Alison C Roxby

Open access · goldAbstract read
In one paragraph

Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Nicholas KipkuruiImpact Research Development Organization, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-6817-6251
Emmah OwidiKenya Medical Research Institute-Center for Clinical Research, Partners in Health Research and Development, Nairobi, Kenya.ORCID https://orcid.org/0000-0003-4167-7897
James AyiekoKenya Medical Research Institute-Center for Microbiology Research, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-0324-4006
Gerald OwuorImpact Research Development Organization, Kisumu, Kenya.ORCID https://orcid.org/0000-0002-0542-510X
Irene MugenyaKenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.ORCID https://orcid.org/0000-0003-4827-5241
Kawango AgotImpact Research Development Organization, Kisumu, Kenya.
Alison C RoxbyUniversity of Washington, Departments of Medicine, Global Health, and Epidemiology, Seattle, WA, United States of America.ORCID https://orcid.org/0000-0001-9449-8062
Impact Research and Development Organization · KEKenya Medical Research Institute · KEUniversity of Washington · US

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
NIAID NIH HHS P30 AI027757
6 · The paper itself

Abstract

In Kenya, adolescents spend much of their formative years in boarding secondary schools, which presents a challenging environment for antiretroviral (ART) adherence support among adolescents living with HIV (ALHIV). We examined the experiences of ALHIV, caregivers of adolescents, and school nurses regarding navigating ART adherence in boarding secondary schools. Between July and November 2022, we conducted focus group discussions (FGDs) among ALHIV attending boarding schools in Nairobi, Kenya, and caregivers of ALHIV, and in-depth interviews (IDIs) with school nurses. Clinic records were used to identify ALHIV and caregivers, who were invited to participate based on their availability. We categorized boarding schools into national, county, and sub-county levels and selected two schools from each category. We obtained permission from head teachers and invited school nurses to take part in virtual IDIs. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. We conducted two FGDs with 11 caregivers, two FGDs with 18 adolescents, and 7 IDIs with school nurses. Most of the ALHIV reported having disclosed their HIV status to a school nurse or teacher during admission. School nurse friendliness, being understanding, fair, and confidential were qualities associated with ALHIV willingness to confide in them. Strategies ALHIV used to adhere to medication included: waiting until students were engaged in other activities, waking up early, stepping away from others, and stating their drugs were for different ailments. Caregivers were nervous about school-based adherence counseling, fearing it could lead to inadvertent disclosure of adolescents' HIV status and stigmatization by fellow students. All school nurses reported lacking appropriate training in HIV adherence counseling for adolescents. ALHIV have devised innovative strategies to navigate pill-taking and enlist quiet support while operating in stigmatized school environments. Establishment of a strong school nurse-adolescent rapport and building nurses' skills are key to improving school-based support for ALHIV.

Identifiers

PMID37747873
PMCPMC10519593
OpenAlexW4387025158

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.