Survey of children accessing HIV services in a high prevalence setting: time for adolescents to count?
OBJECTIVE
To establish the proportion of adolescents among children infected with human immunodeficiency virus (HIV) in Zimbabwe who receive HIV care and support, and what clinic staff perceives to be the main problems faced by HIV-infected children and adolescents.


METHODS
In July 2008, we sent a questionnaire to all 131 facilities providing HIV care in Zimbabwe. In it we requested an age breakdown of the children (aged 0-19 years) registered for care and asked what were the two major problems faced by younger children (0-5 years) and adolescents (10-19 years).


RESULTS
Nationally, 115 (88%) facilities responded. In 98 (75%) that provided complete data, 196 032 patients were registered and 24 958 (13%) of them were children. Of children under HIV care, 33% were aged 0-4 years; 25%, 5-9 years; 25%, 10-14 years; and 17%, 15-19 years. Staff highlighted differences in the problems most commonly faced by younger children and adolescents. For younger children, such problems were malnutrition and lack of appropriate drugs (cited by 46% and 40% of clinics, respectively); for adolescents they concerned psychosocial issues and poor drug adherence (cited by 56% and 36%, respectively).


CONCLUSIONS
Interventions for the large cohort of adolescents who are receiving HIV care in Zimbabwe need to target the psychosocial concerns and poor drug adherence reported by staff as being the main concerns in this age group.
London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, England. rashida.ferrand@lshtm.ac.uk
Rashida
R
Ferrand
Sara
S
Lowe
Barbra
B
Whande
Lucia
L
Munaiwa
Lisa
L
Langhaug
Frances
F
Cowan
Owen
O
Mugurungi
Diana
D
Gibb
Shungu
S
Munyati
Brian G
BG
Williams
Elizabeth L
EL
Corbett
D000293:Adolescent; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013997:Time Factors; D015030:Zimbabwe / Q000453:epidemiology; D016903:Drug Monitoring