You can treat my HIV ­ but can you treat my blood pressure? availability of integrated HIV and non-communicable disease care in northern Malawi

Background: Many patients on antiretroviral therapy (ART) in Malawi have or will develop non-communicable diseases(NCDs). The current capacity of ART sites to provide care for NCDs is not known. Aim: This study aimed to assess the capacity of ART sites to provide care for hypertension and diabetes in rural Malawi.Setting: Twenty-five health centres and five hospitals in two rural districts in northern Malawi. Methods: A cross-sectional survey was performed between March and May 2014 at all facilities. Qualitative interviews were held with three NCD coordinators. Results: Treatment of hypertension and diabetes was predominantly hospital-based. Sixty percent of hospitals had at least one clinician and one nurse trained in NCD care, whereas 5% of health centres had a clinician and 8% had a nurse trained in NCD care. Hundred percent of hospitals and 92% of health centres had uninterrupted supply of hydrochlorothiazide in the previous 6 months, but only 40% of hospitals and no health centres had uninterrupted supply of metformin. Hundred percent of hospitals and 80% of health centres had at least one blood pressure machine, and 80% of hospitals and 32% of health centres had one glucometer. Screening for hypertension amongst ART patients was only conducted at one hospital and no health centres. At health centres, integrated NCD and ART care was more common, with 48% (12/25) providing ART and NCD treatment in the same consultation. Conclusions: The results reflect the status of the initial stages of the Malawi NCD programme at sites currently providing ART care

Knowledge, attitude and practice study of HIV in female adolescents presenting for contraceptive services in a rural health district in the north-east of Namibia

Background: Namibia bears a large burden of Human Immunodeficiency Virus (HIV); and the youth are disproportionately affected. Objectives: To explore the current knowledge; attitudes and behaviour of female adolescents attending family planning to HIV prevention. Methods: A cross-sectional study design was used on a sample 251 unmarried female adolescents aged from 13 years to 19 years accessing primary care services for contraception using an interviewer-administered questionnaire. Data were analysed using Epi Info 2002. Crude associations were assessed using cross-tabulations of knowledge; attitude and behaviour scores against demographic variables. Chi-square tests and odds ratios were used to assess associations from the cross-tabulations. All p-values 0.05 were considered statistically significant. Results: A quarter of sexually active teenagers attending the family-planning services did not have adequate knowledge of HIV prevention strategies. Less than a quarter (23.9) always used a condom. Most respondents (83.3) started sexual intercourse when older than 16 years; but only 38.6used a condom at their sexual debut. The older the girls were at sexual debut; the more likely they were to use a condom for the event (8did so at age 13 years and 100at age 19 years). Conclusions: Knowledge of condom use as an HIV prevention strategy did not translate into consistent condom use. One alternate approach in family-planning facilities may be to encourage condom use as a dual protection method. Delayed onset of sexual activity and consistent use of condoms should be encouraged amongst schoolchildren; in the school setting