Institutional and social dynamics of providing care and support to 15–19 year old adolescents living with HIV and AIDS in Botswana

ABSTRACT

The majority of HIV positive adolescents aged 15–19 years in Botswana, got infected through vertical transmission. In 2013, the HIV prevalence among 15–19 year olds was 5% when compared to 3.7% in 2008. The national HIV prevalence was 18.5% in 2013 (females; 19.2% and males 14.1%). There was a slight increase from 2008 which was 17.6% (20.4% for females and 14.2% for males). In 2013, 4833 teenagers aged 15—19 years old were enrolled in the government ARV programme (56% female and 44% males). Adolescents living with HIV and AIDS (ALWHA) and their parents and guardians face numerous challenges that require systematic investigation. The overall objective of this paper is to assess different types of care and support for 15–19 year old ALWHA provided by health care providers (HCPs), parents and guardians. The study utilized a qualitative exploratory design. In-depth interviews were conducted among 25 HCPs and 8 parents or guardians; and focus group discussions were conducted with 26 ALWHA (10 males and 16 females) from Mochudi and Gaborone. Thematic content analysis was employed in data analysis. The main challenges reported by adolescents, HCPs, parents and guardians included those relating to institutional, family, school and community care and support. These challenges undermine provision of available care and support services provided by parents and guardians and HCPs. The findings of the study will inform the design of an effective social network and support systems for ALWHA and their parents/guardians.

KEYWORDS:

• Caregivers
• ALWHA
• health care providers
• support systems
• effective interventions
• psychosocial needs

Acknowledgements

The authors thank ALWHA, parents/guardians, HCPs,

University of Pennsylvania and University of Botswana for support and guidance.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institutes of Health (NIH) [grant number R24HDO056693-05].