Knowledge, attitudes and practices among parents towards human immuno-deficiency virus (HIV) testing and treatment for children: the case of Addis Ababa, Ethiopia

Despite the availability of services, parents on antiretroviral treatment do not routinely get their children HIV tested and treated. The study aimed to document knowledge, attitudes and practices of parents towards HIV testing and treatment among children aged 0-14 years. A quantitative cross-sectional analytic study design was applied and a structured questionnaire used to collect data from 192 respondents. Findings show that 71.4% of respondents had correct knowledge of HIV transmission in children. Negative attitudes towards HIV testing of children were expressed by 42.2% of respondents while practices were reported by 16.7%. Practices were associated with self-efficacy, stigma, number of children and marital status. Knowledge and attitudes did not affect parental practices of HIV testing of children. Parents with low self-efficacy felt stigmatised, had negative attitudes, poor perception of availability of services and were unlikely to get children HIV tested. Recommendations to increase HIV testing among children included provision of skills and support to parents for HIV disclosure; localized care models to reduce stigma and identify children in need; and improving quality of services.Health StudiesM.A. (Public Health

Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe

BACKGROUND: Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIV-positive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment, emotional underdevelopment, illiteracy, poverty, sexual exploitation, and HIV infection, endangering the future health of the society they are expected to sustain. METHODS: To explore barriers and possible incentives to orphan care, a quantitative cross-sectional survey in rural eastern Zimbabwe asked 371 adults caring for children, including 212 caring for double orphans, about their well-being, needs, resources, and perceptions and experiences of orphan care. RESULTS: Survey responses indicate that: 1) foster caregivers are disproportionately female, older, poor, and without a spouse; 2) 98% of non-foster caregivers are willing to foster orphans, many from outside their kinship network; 3) poverty is the primary barrier to fostering; 4) financial, physical, and emotional stress levels are high among current and potential fosterers; 5) financial need may be greatest in single-orphan AIDS-impoverished households; and 6) struggling families lack external support. CONCLUSION: Incentives for sustainable orphan care should focus on financial assistance, starting with free schooling, and development of community mechanisms to identify and support children in need, to evaluate and strengthen families' capacity to provide orphan care, and to initiate and support placement outside the family when necessary

The missed HIV-positive children of Ethiopia

Objective: As elsewhere, due to scarcity of data and limited awareness of HIV infection, especially in older children, the HIV epidemic among Ethiopian children appears neglected in national programs (children ART coverage is of only 12% in 2013). This paper estimates the country burden of HIV in older children and investigates the prevalence of HIV in orphans and vulnerable children (OVC) households. Design/Methods: We analyzed national HIV data for Ethiopia, using Spectrum/ Estimation and Projection Package (EPP) and primary data on children living in households with at least one HIV-positive adult in the Amhara and Tigrai regions. Descriptive analysis of the age and sex distribution of HIV-positive OVC in Ethiopia was performed. Results: Our Spectrum/EPP analysis estimated the population of HIV-positive children under 15 years old to be 160,000 in 2013. The majority of children (81•6%) were aged five to 14 years. The estimated number of orphans due to AIDS was 800,000. The empirical data from almost 10,000 OVC under 18 years showed 11•9% were HIV-positive, the majority of whom were between five and 10 years old with no significant difference between males and females. Conclusions: There is a large population of children living with HIV in Ethiopia, the magnitude of which not previously recognized. The majority were vertically infected and never identified nor linked into treatment. OVC represent a reachable group which could account for a substantial proportion of the HIV infected older children. We recommend that HIV programs urgently synergize with social protection sectors and address these children with HIV testing and related services

Age distribution of (a) HIV-negative and (b) HIV-positive among OVC supported by NNPWE through the USAID ENHAT-CS program, Amhara and Tigrai regions, Ethiopia, 2013.

<p>Age distribution of (a) HIV-negative and (b) HIV-positive among OVC supported by NNPWE through the USAID ENHAT-CS program, Amhara and Tigrai regions, Ethiopia, 2013.</p

Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe-1

<p><b>Copyright information:</b></p><p>Taken from "Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe"</p><p>BMC Public Health 2006;6():27-27.</p><p>Published online 9 Feb 2006</p><p>PMCID:PMC1403763.</p><p>Copyright © 2006 Howard et al; licensee BioMed Central Ltd.</p>orphans' life chances, more likely to believe biological children should be given preference, and least likely to believe that caregivers who take in orphans gain community respect. Perceptions of this kind may limit potential caregivers' motivation to step forward for fostering, especially extra-familial fostering

Number of maternal AIDS orphans, by age, 2013 (A).

<p>(A) EPP/Spectrum estimates, 2012.</p

Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe-0

<p><b>Copyright information:</b></p><p>Taken from "Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe"</p><p>BMC Public Health 2006;6():27-27.</p><p>Published online 9 Feb 2006</p><p>PMCID:PMC1403763.</p><p>Copyright © 2006 Howard et al; licensee BioMed Central Ltd.</p>. In households severely affected by AIDS (B), most of which contained single orphans, caregivers reported the most severe problems