Understanding the psychosocial needs of HIV-infected children and families: a qualitative study.

OBJECTIVE: This study aims to engage children living with HIV/AIDS and their caregivers in a qualitative assessment to address psychosocial needs pertaining to this population. The purpose is to identify unique situations and concerns they experienced in dealing with the disease and ongoing treatment process. MATERIAL AND METHOD: Individual in-depth interviews using a semi-structured interview guide were employed. RESULTS: Thirty-four children (12 boys and 22 girls) aged 8-16 and thirty-five primary caretakers (6 males and 29 females) aged 21-66 participated in this study. Results identified some of the common concerns and challenges shared among this population, including impact of the illness on loved ones, disclosure, adherence, behavioural problems, discrimination, treatment affordability, and financial constraints. Certain issues that emerged as important themes specific to this population include unwarranted concerns about certain aspects of the illness, misinterpretation of the nonverbal clues within families, future child guardianship and placement planning, treatment availability during transitional period, and the challenge of maintaining the confidentiality of the diagnosis. CONCLUSION: The needs and suggestions of the target groups provided the framework for improving the current services such as the provision of private sessions with children separated from their caregivers (especially for older children and adolescents), disclosure intervention, behavioral screening, life skills building, and empowerment mobilization. Thus, the information gained can be used to facilitate the holistic and humanized health care provision for children living with HIV/AIDS.

Risk factors associated with continued heroin use during methadone maintenance treatment in Guizhou province, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the proportion of methadone maintenance treatment (MMT) clients continuing to use heroin and to explore its associated risk factors.</p><p><b>METHODS</b>All 1003 heroin addictive patients were recruited from eight MMT clinics in Guizhou province and followed up for 14 months. During the 14 months, each MMT client received random urine tests. MMT clinics, gender, marital status, employment, ethnicity, religion, previous drug using method, having a history being in detoxification program, age, methadone dosage, education level and length of drug use were treated as potential predicting variables into the GEE model.</p><p><b>RESULTS</b>The average age of the 1003 clients was (33.3 +/- 6.1) years old, the average length of drug use was (8.0 +/- 4.0) years, and the average daily methadone dosage was (38.0 +/- 16.6) mg. Among the 1003 clients, 26.0% were female drug users, 15.5% were divorced and 35.8% had a full time job. The rate of positive urine samples was approximately 30% for the first 10 months of follow-up, after which the positive rate decreased. The model found that different MMT clinics, the average daily methadone dosage (RR = 0.98, P = 0.003), treatment duration (RR = 0.95, P = 0.029) and years of education (RR = 0.94, P = 0.014) were associated with patients positive urine test.</p><p><b>CONCLUSION</b>Continued heroin use was common in MMT clinics in Guizhou province; increasing the dosage of methadone and the duration in the treatment program might decrease the continued use of heroin among clients in MMT clinics.</p>