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Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated

Alisat Sadiq1, Richard Kwizera2,3, Tadeo K Kiiza1

  • 1Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O. Box 22418, Kampala, Uganda.

AIDS Research and Therapy
|February 19, 2025
PubMed

Insights

Counselling individuals with advanced HIV disease (AHD)-related meningitis in Uganda presents unique challenges. Addressing these barriers through tailored strategies is crucial for improving patient outcomes and care.

Area of Science:

  • Public Health
  • Infectious Diseases
  • HIV/AIDS Management

Background:

  • Advanced HIV disease (AHD) remains a significant public health issue in Uganda, despite widespread antiretroviral therapy (ART) access.
  • Meningitis is a leading cause of illness and death among individuals with AHD.
  • Effective HIV counselling is vital for managing AHD-related meningitis.

Purpose of the Study:

  • To describe the experiences and challenges encountered during counselling for AHD-related meningitis in Uganda.
  • To identify strategies used to overcome these challenges.
  • To highlight health system gaps and propose solutions for improved care.

Main Methods:

  • Qualitative description of counselling experiences and challenges.
  • Documentation of strategies employed to address identified challenges.
  • Analysis of health system gaps and formulation of recommendations.

Main Results:

  • Key challenges include altered mental status, unknown HIV status, family non-disclosure, limited ART history, caretaker issues, pill burden, side effects, invasive procedures, myths, poverty, and lack of privacy.
  • Patients and caretakers often seek non-medical interventions (religious, traditional, herbal) alongside or instead of medical treatment.
  • Strategies to overcome challenges involve tailored communication, involving caretakers, simplifying regimens, and ensuring privacy.

Conclusions:

  • Individuals with AHD-related meningitis require specialized, daily counselling as an integral part of their care.
  • Addressing psychosocial, economic, and health system factors is essential for optimizing treatment outcomes.
  • Integrated care approaches are necessary to manage the complex needs of this patient population.
Abstract

Keywords:
Advanced HIV DiseaseCounsellingHIVMeningitisUganda

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