2 research outputs found
Implication of antiretrovival therapy on children's health-related quality of life in conflict situation = Gesundheitsbezogene Auswirkungen der antiretroviralen Therapie auf die Lebensqualität bei Kindern in Konfliktsituationen ; eine Untersuchung aus dem Bezirk Gulu, Uganda
Diese Studie beschäftigt sich mit den Auswirkungen der Verabreichung von antiretroviralen Medikamenten an Kinder, die mit HIV infiziert sind und in der semi-urbanen Umgebung im Bezirk Gulu, Norduganda, leben. Ziel war es, die Lebensqualität hinsichtlich der gesundheitlichen Entwicklung dieser Kinder, die eine antiretrovirale Therapie erhalten, unter Berücksichtigung der Folgen des Bürgerkriegs, zu untersuchen.
Die Studie erfolgte anhand eines Begriffsmodels auf Basis von Literatur. Es wird angenommen, dass die vorgeschlagenen Faktoren in diesem Begriffsmodel interagieren und die Einstellung zu Therapien der Betroffenen, allgemeinem Zugang zu medizinischer Versorgung und zur Einhaltung der Behandlungsmethoden, um die Lebensqualität zu verbessern, beeinflussen.
Die Faktoren, welche innerhalb der Bürgerkriegssituation interagieren, beinhalten: Die Rolle der Politik und NGOs, gesundheitsbeeinflußende Faktoren, soziokulturelle Charakteristika, Gesundheitssysteme, Einstellungen zu Gesundheit, psychosoziale Faktoren, Indikatoren zur Belastbarkeit einer Familie und gesundheitsbezogene Parameter über Lebensqualität und Gesamtgesundheit.
Zur qualitativen Datenerhebung wurden ethnographische Forschungsmethoden angewandt um den Alltag der Kinder, welche eine antiretrovirale Therapie erhalten, in ihrem Haushaltsumfeld zu untersuchen. Die Datensammlung wurde mit dem Instrument des triangularen Forschungsinstruments – Sekundärdaten, Tiefeninterviews mit Informanten in Schlüsselpositionen, den Müttern der Kinder, Gruppendiskussionen und teilnehmender Beobachtung erarbeitet. Die Datenerhebung fand in zwei sechsmonatigen Perioden statt, in welchen 19 Tiefeninterviews mit Müttern, fünf mit Informanten in Schlüsselpositionen und vier Gruppendiskussionen mit teilnehmender Beobachtung durchgeführt wurden.
FĂĽr die thematische Datenanalyse wurde offenes, axiales und selektives Kodieren unter Anwendung von Atlas.ti 6 (eine Software zur Textanalyse) angewendet. Die Netzwerkanalyse der Codes generierte Themen, welche in der Dissertation diskutiert wurden. Ergebnisse der Analyse wurden mit den Informanten gegengeprĂĽft und ein Nachweis wurde im Validationsprozess erbracht.
Durch die Studie wurde bewiesen, dass, trotz gegenteiliger Argumente, der Bürgerkrieg negativen Einfluss auf die HIV/AIDS Epidemiologie in Form von erhöhter Armut, Verlust von Eigentum und Leben, Zerstörung der Gesundheitsinfrastruktur und geschwächten Haushalten hat.
Trotz aller Herausforderungen kann unter bestimmten Bedingungen die Lebensqualität der Kinder unter antiretroviraler Therapie wesentlich verbessert werden obwohl die Haushalte nicht voll belastbar sind, das Gesundheitssystem inadequat ist, sowie die nationalen und internationalen Gelder gekürzt werden. Die erzielten Erfolge sind in Gefahr, weil viele Kinder noch gar nicht mit der antiretroviralen Therapie begonnen haben. Die Studie brachte ebenso hervor, dass Best Practices wie Kindertage und das Präventionsprojekt von lokalen Organisationen wie TASO und Health Alert-Uganda nachhaltig positive Resultate im Rahmen der antiretroviralen Therapie erbringen.
Aufgrund der mangelnden qualitativen Daten über die Lebensqualität HIV-infizierter Menschen in ökonomisch benachteiligten Gebieten, möchte die Studie auch zu mehr Forschung in diesem Gebiet auffordern. Da die Finanzierung das Hauptproblem darstellt, ist eine bessere Unterstützung durch die Regierung notwendig. Die Erstellung von Richtlinien zur Kosteneffizienz dieser Best Practices, welche derzeit von regionalen Hilfsorganisationen durchgeführt werden, ist notwendig.This study explored the response to Antiretroviral (ARV) drug use by children living with HIV among communities within the vicinity of Gulu district municipality in northern Uganda. The aim was to look at the quality of life as the health outcomes of treatment for these children accessing ART in the context of civil conflict. The study was guided by an annotated conceptual framework informed by literature, where by suggested factors are thought to interact to influence the health seeking behaviour, general treatment access and adherence practices which results in better quality of life. These factors operating within the conflict environment include government policies and NGO functions, health determinants, sociocultural characteristics, health systems, health behaviour and psychosocial factors, family resilience indicators, health-related quality of life parameters and quality of life outcomes.
The exploratory qualitative study employed ethnographic research method to look at the daily life experience of children living with HIV/AIDS and are undergoing antiretroviral therapy (ART) within their households’ living environment. Data collection was done using triangulated study tools of document reviews, in-depth interviews with respondents and key informants, focus group discussions and participants’ observation. Data collection was done in two phases of six months each in which nineteen in-depth interviews, five key informants’ interviews, and four focus group discussions were done.
Thematic data analysis was used in which open, axial and selective coding for data reduction and analysis was done aided by Atlas.ti 6 computer software for text analysis. The thematic network analysis of the codes generated key themes that were used to discuss the thesis. Outcomes from the analysis were crosschecked with respondents and an audit trail made as a validation process.
The study findings have revealed that despite major arguments about the impact of conflict on the spread of HIV/AIDS, the LRA conflict indeed negatively impacted on the HIV/AIDS epidemiology through increase in poverty, loss of property and lives, destruction of health infrastructure, as well as increased households’ vulnerability. However amidst all these challenges, within certain conditions, treatment outcomes shown by the quality of life of these children on ART have yielded pretty good results; yet with poor social resilience, health systems inadequacy, limited government funding of the health sector couple with dwindling donor funds, the gains are seriously threatened, considering that many more children are yet to even start on the ART. The study also found that best practices such as children’s days and positive prevention project by local community based organisations like TASO and Health Alert-Uganda are yielding positive results in the scale up of ART.
Due to lack of data on quality of life related to HIV in resource limited settings, the study calls for more research in this field and as funds remain a major problem to policy makers, better government support are urged to make guidelines that incorporate cost effective, best practices that are currently being used by grass root organisations
“I Use Strawberry Flavoured Condoms during My Periods”: Safe Sex Practices and STI Screening Behaviours among Female Sex Workers in Gulu City, Uganda
Background: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging health-risk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility, empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized population