'They Can Stigmatize You': A Qualitative Assessment of the Influence of School Factors on Engagement in Care and Medication Adherence among Adolescents with HIV in Western Kenya

Autor/inn/en	Wiggins, Lisa; O'Malley, Gabrielle; Wagner, Anjuli D.; Mutisya, Immaculate; Wilson, Kate S.; Lawrence, Sarah; Moraa, Hellen; Kinuthia, John; Itindi, Janet; Muhenje, Odylia; Chen, Tai-Ho; Singa, Benson; Mcgrath, Christine J.; Ngugi, Evelyn; Katana, Abraham; Ng'ang'a, Lucy; John-Stewart, Grace; Kholer, Pamela; Beima-Sofie, Kristin
Titel	'They Can Stigmatize You': A Qualitative Assessment of the Influence of School Factors on Engagement in Care and Medication Adherence among Adolescents with HIV in Western Kenya
Quelle	In: Health Education Research, 37 (2022) 5, S.355-363 (9 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Wiggins, Lisa) ORCID (John-Stewart, Grace)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0268-1153
DOI	10.1093/her/cyac018
Schlagwörter	Foreign Countries; Adolescents; Acquired Immunodeficiency Syndrome (AIDS); Caregivers; Educational Environment; Compliance (Psychology); Drug Therapy; Patients; Clinics; Health Services; Social Discrimination; Teacher Attitudes; Peer Relationship; Peer Influence; Kenya + Suchen Sie Ihr Suchwort? Ausland; Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Caregiver; Carer; Betreuungsperson; Pfleger; Lernumgebung; Pädagogische Umwelt; Schulumwelt; Patient; Health service; Gesundheitsdienst; Gesundheitswesen; Soziale Benachteiligung; Soziale Schließung; Lehrerverhalten; Peer-Beziehungen; Kenia
Abstract	School-related factors may influence retention in care and adherence to antiretroviral therapy (ART) among adolescents with human immunodeficiency virus (HIV). We analyzed data from in-depth interviews with 40 adolescents with HIV (aged 14-19 years), 40 caregivers of adolescents with HIV, and 4 focus group discussions with healthcare workers to evaluate contextual factors affecting adherence to ART and clinic attendance among adolescents, with a focus on the school environment. Informed by Anderson's Model of Health Services Utilization, transcripts were systematically coded and synthesized to identify school-related themes. All groups identified the school environment as a critical barrier to engagement in HIV care and medication adherence for adolescents with HIV. Adolescent participants reported inflexible school schedules and disclosure to school staff as the biggest challenges adhering to clinic appointments and ART. Adolescents described experiencing stigma and discrimination by peers and school staff and would adjust when, where and how often they took ART to avoid inadvertent disclosure. Boarding school students faced challenges because they had limited private space or time. Caregivers were often instrumental in navigating school permissions, including identifying a treatment supporter among school staff. Additional research engaging school staff may guide interventions for schools to reduce stigma and improve adherence and retention. (As Provided).
Anmerkungen	Oxford University Press. Great Clarendon Street, Oxford OX2 6DP, UK. Tel: +44-1865-353907; Fax: +44-1865-353485; e-mail: jnls.cust.serv@oxfordjournals.org; Web site: http://her.oxfordjournals.org/
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01