Browsing by Author "Nyonyitono, Maureen"

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    Feasibility and acceptability of mobile phone short message service as a support for patients receiving antiretroviral therapy in rural Uganda: a cross-sectional study
    (Wiley-Blackwell, 2015-12) Kim, Jiho; Zhang, Wendy; Nyonyitono, Maureen; Lourenco, Lillian; Nanfuka, Mastula; Okoboi, Stephen; Birungi, Josephine; Lester, Richard T.; Kaleebu, Pontiano; Munderi, Paula; Moore, David M.
    Introduction: Mobile phone technologies have been promoted to improve adherence to antiretroviral therapy (ART).We studied the receptiveness of patients in a rural Ugandan setting to the use of short messaging service (SMS) communication for such purposes. Methods: We performed a cross-sectional analysis measuring mobile phone ownership and literacy amongst patients of The AIDS Support Organisation (TASO) in Jinja, Uganda. We performed bivariate and multivariate logistic regression analyses to examine associations between explanatory variables and a composite outcome of being literate and having a mobile phone. Results: From June 2012 to August 2013, we enrolled 895 participants, of whom 684 (76%) were female. The median age was 44 years. A total of 576 (63%) were both literate and mobile phone users. Of these, 91% (527/ 576) responded favourably to the potential use of SMS for health communication, while only 38.9% (124/319) of others were favourable to the idea (pB0.001). A lower proportion of literate mobile phone users reported optimal adherence to ART (86.4% vs. 90.6%; p=0.007). Male participants (AOR=2.81; 95% CI 1.83=4.30), sub-optimal adherence (AOR=1.76; 95%CI 1.12=2.77), thosewithwaged or salaried employment (AOR=2.35; 95% CI 1.23=4.49), crafts/trade work (AOR=2.38; 95% CI 1.11=5.12), or involved in petty trade (AOR=1.85; 95% CI 1.09=3.13) (in comparison to those with no income) were more likely to report mobile phone ownership and literacy. Conclusions: In a rural Ugandan setting, we found that over 60% of patients could potentially benefit from a mobile phone-based ART adherence support. However, support for such an intervention was lower for other patients.
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    ‘People say that we are already dead much as we can still walk’: a qualitative investigation of community and couples’ understanding of HIV serodiscordance in rural Uganda
    (BioMed Central Ltd, 2016) Kim, Jiho; Nanfuka, Mastula; Moore, David; Shafic, Murisho; Nyonyitono, Maureen; Birungi, Josephine; Galenda, Florence; King, Rachel
    Background: Stable, co-habiting HIV serodiscordant couples are a key population in terms of heterosexual transmission in sub-Saharan Africa. Despite the wide availability of antiretroviral treatment and HIV educational programs, heterosexual transmission continues to drive the HIV epidemic in Africa. To investigate some of the factors involved in transmission or maintenance of serodiscordant status, we designed a study to examine participants’ understanding of HIV serodiscordance and the implications this posed for their HIV prevention practices. Methods: In-depth interviews were conducted with 28 serodiscordant couples enrolled in a treatment-asprevention study in Jinja, Uganda. Participants were asked questions regarding sexual behaviour, beliefs in treatment and prevention, participants’ and communities’ understanding and context around HIV serodiscordance. Qualitative framework analysis capturing several main themes was carried out by a team of four members, andwas cross-checked for consistency. Results: It was found that most couples had difficulty explaining the phenomenon of serodiscordance and tended to be confused regarding prevention. Many individuals still held beliefs in pseudoscientific explanations for HIV susceptibility such as blood type and blood “strength”. The participants’ trust of treatment and medical services were well established. However, the communities’ views of both serodiscordance and treatment were more pessimistic and wrought with mistrust. Stigmatization of serodiscordance and HIV-positive status were reported frequently. Conclusions: The results indicate that despite years of treatment and prevention methods being available, stigmatization and mistrust persist in the communities of HIV-affected individuals and may directly contribute to new cases and seroconversion. We suggest that to optimize the effects of HIV treatment and prevention, clear education and support of such methods are sorely needed in sub-Saharan African communities.