title: Communication between HIV-infected children and their caregivers about HIV medicines: a cross-sectional study in Jinja district, Uganda.
abstract: BACKGROUND
  Knowledge of antiretroviral therapy (ART) among children with HIV depends on open communication with them about their health and medicines. Guidelines assign responsibility for communication to children's home caregivers. Other research suggests that communication is poor and knowledge about ART is low among children on treatment in low-income countries. This study sought to describe communication about medicine for HIV in quantitative terms from the perspectives of both children and caregivers. Thereafter, it established the factors associated with this communication and with children's knowledge about their HIV medicines.
  
  
  METHODS
  We undertook a cross-sectional survey of a random sample of 394 children with HIV on treatment and their caregivers at nine health facilities in Jinja District, Uganda. We assessed reported frequency and content of communication regarding their medicines as well as knowledge of what the medicines were for. Logistic regression analysis was used to determine the factors associated with communication patterns and children's knowledge of HIV medicines.
  
  
  RESULTS
  Although 79.6% of the caregivers reported that they explained to the children about the medicines, only half (50.8%) of the children said they knew that they were taking medicines for HIV. Older children aged 15-17 years were less likely to communicate with a caregiver about the HIV medicines in the preceding month (OR 0.5, 95% CI 0.3-0.7, p=0.002). Children aged 11-14 years (OR 6.1, 95% CI 2.8-13.7, p<0.001) and 15-17 years (OR 12.6, 95% CI 4.6-34.3, p<0.001) were more likely to know they were taking medicines for HIV compared to the younger ones. The least common reported topic of discussion between children and caregivers was "what the medicines are for" while "the time to take medicines" was by far the most mentioned by children.
  
  
  CONCLUSIONS
  Communication about, and knowledge of, HIV medicines among children with HIV is low. Young age (less than 15 years) was associated with more frequent communication. Caregivers should be supported to communicate diagnosis and treatment to children with HIV. Age-sensitive guidelines about the nature and content of communication should be developed.
authors.affiliation: Child Health and Development Centre, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; phoebekajubi@yahoo.com.
authors.forename: Phoebe
authors.initials: P
authors.lastname: Kajubi
authors.affiliation: Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Susan
authors.initials: S
authors.lastname: Whyte
authors.affiliation: Child Health and Development Centre, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Simon
authors.initials: S
authors.lastname: Muhumuza
authors.affiliation: Child Health and Development Centre, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Kyaddondo
authors.affiliation: Child Health and Development Centre, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Katahoire
mesh_terms: D000293:Adolescent; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods* / Q000523:psychology; D017028:Caregivers; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents
keywords: HIV disclosure; Uganda; antiretroviral therapy; children with HIV; therapeutic communication