MPhil study projects

Primary caregivers’ role in HIV prevention among adolescent girls at Eshowe, KZN

Student: Gcinekile Mdlalose

Country: South Africa

Primary caregivers play a crucial role in providing life skills and HIV/Aids education to young people, including sex education, which demands effective communication skills. The significance of effective caregiver-child communication influences healthy decision-making in adolescents. This study investigated the involvement of primary caregivers of girls aged 10-14 in HIV education.

Conducted in Eshowe, KwaZulu-Natal, the study employed qualitative methods, engaging 15 primary caregivers through focus groups with open-ended questions. Thematic analysis revealed insights into caregiver perspectives and practices. The results indicated that 87% of caregivers were young women, with a strong awareness of HIV risk factors for adolescent girls. Many however avoided discussing sexuality with adolescents. Reasons cited included discomfort and the perception that adolescents are too young for such discussions.

The study underscored the critical role of caregiver-adolescent communication in HIV prevention. It highlighted the need for training and workshops to equip caregivers with culturally sensitive communication tools for addressing sexuality and HIV/Aids topics effectively with young people under their care.

Adherence levels were assessed using a three-day recall method, yielding an adherence mean of 95,5%. Gender disparities were observed, with males averaging 94,4% adherence and females 96,2%. The study identified pill fatigue, stigma, adolescents’ daily activities and disclosure of HIV status by extended family members as significant contributors to poor adherence.

To address these issues, reinforcing adherence counselling and education during medical visits regarding the importance of ART, the risk of stigma and low self-esteem is crucial. Supporting visits should be increased and the use of reminders, such as alarms and phone calls, should be intensified, particularly for adolescents who experience adherence challenges.

Findings revealed that 15 SAM patients transitioned to the next rehabilitation phase in the MAM programme, while 13 MAM patients achieved successful recovery based on BMI assessment. Healthcare workers often deviated from rehabilitation guidelines due to shortages of essential nutritional commodities, forcing them to improvise with available resources.

Recommendations stressed the need for larger-scale nationwide studies. A dearth of literature on SAM and MAM management in HIV-positive populations is compounded by discrepancies between practices and national guidelines due to resource constraints. This disconnect underscores the potential for misleading results and highlights the need for improved resource allocation and adherence to established protocols.

Findings revealed that SMMEs generally offer employment conditions favourable for promoting treatment adherence among employees on chronic medication. Accessibility to treatment at health facilities and employees’ understanding of their medical conditions were noted as strengths. Formal workplace policies addressing basic conditions of employment, labour relations and HIV and tuberculosis wellness were however found to be inadequate. More than half of the respondents reported difficulties in adhering to medication schedules at work, pointing to challenges in taking medication at the correct time, skipping doses and experiencing medication-related work interference.