Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda
Abstract Background Advanced HIV disease (AHD) is still a significant problem in Uganda despite the test-and-treat strategy and the increased access to antiretroviral therapy (ART). Meningitis remains a major cause of morbidity and mortality in people with AHD. HIV counselling is essential and plays...
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BMC
2025-02-01
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| Series: | AIDS Research and Therapy |
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| Online Access: | https://doi.org/10.1186/s12981-025-00705-z |
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| author | Alisat Sadiq Richard Kwizera Tadeo K Kiiza Peruth Ayebare Cynthia Ahimbisibwe Jane Frances Ndyetukira David R Boulware David B. Meya |
| author_facet | Alisat Sadiq Richard Kwizera Tadeo K Kiiza Peruth Ayebare Cynthia Ahimbisibwe Jane Frances Ndyetukira David R Boulware David B. Meya |
| author_sort | Alisat Sadiq |
| collection | DOAJ |
| description | Abstract Background Advanced HIV disease (AHD) is still a significant problem in Uganda despite the test-and-treat strategy and the increased access to antiretroviral therapy (ART). Meningitis remains a major cause of morbidity and mortality in people with AHD. HIV counselling is essential and plays an important role in managing persons with AHD-related meningitis. We sought to describe the experiences and challenges we faced during counselling of these individuals, highlighting the strategies, gaps and how we can fill them. Methods First, we describe our experience and major challenges in counselling people with AHD-related meningitis. Second, we describe the strategies we used to overcome each of these challenges. Third, we highlight the health system gaps and recommend solutions. Results Major challenges include the presence of altered mental status, unknown HIV status at admission, non-disclosure of HIV status to family, insufficient ART history, caretakers-related challenges, pill burden, multiple drug side effects, invasive clinical procedures, myths about medical procedures, poverty, lack of privacy during counselling in the wards, patients/caretakers seeking alternative non-medical interventions including religious, traditional, and herbal therapies before and after initiating meningitis treatment. Conclusions Persons with AHD-related meningitis need daily and special consideration during counselling as part of the package of care to improve treatment outcomes. Trial registrations NCT01075152 (23 Feb 2010), NCT01802385 (28 Feb 2013), ISRCTN42218549 (24 April 2018), ISRCTN72509687 (13 July 2017), NCT04031833 (01 January 2019), ISRCTN15668391 (23 May 2019), ISRCTN18437550 (05/11/2021). |
| format | Article |
| id | doaj-art-2f6ddd53e5dd4f7d83946a2586657047 |
| institution | OA Journals |
| issn | 1742-6405 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj-art-2f6ddd53e5dd4f7d83946a25866570472025-08-20T02:15:12ZengBMCAIDS Research and Therapy1742-64052025-02-012211810.1186/s12981-025-00705-zExperiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in UgandaAlisat Sadiq0Richard Kwizera1Tadeo K Kiiza2Peruth Ayebare3Cynthia Ahimbisibwe4Jane Frances Ndyetukira5David R Boulware6David B. Meya7Infectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityDivision of Infectious Diseases and International Medicine, Department of Medicine, University of MinnesotaInfectious Diseases Institute, College of Health Sciences, Makerere UniversityAbstract Background Advanced HIV disease (AHD) is still a significant problem in Uganda despite the test-and-treat strategy and the increased access to antiretroviral therapy (ART). Meningitis remains a major cause of morbidity and mortality in people with AHD. HIV counselling is essential and plays an important role in managing persons with AHD-related meningitis. We sought to describe the experiences and challenges we faced during counselling of these individuals, highlighting the strategies, gaps and how we can fill them. Methods First, we describe our experience and major challenges in counselling people with AHD-related meningitis. Second, we describe the strategies we used to overcome each of these challenges. Third, we highlight the health system gaps and recommend solutions. Results Major challenges include the presence of altered mental status, unknown HIV status at admission, non-disclosure of HIV status to family, insufficient ART history, caretakers-related challenges, pill burden, multiple drug side effects, invasive clinical procedures, myths about medical procedures, poverty, lack of privacy during counselling in the wards, patients/caretakers seeking alternative non-medical interventions including religious, traditional, and herbal therapies before and after initiating meningitis treatment. Conclusions Persons with AHD-related meningitis need daily and special consideration during counselling as part of the package of care to improve treatment outcomes. Trial registrations NCT01075152 (23 Feb 2010), NCT01802385 (28 Feb 2013), ISRCTN42218549 (24 April 2018), ISRCTN72509687 (13 July 2017), NCT04031833 (01 January 2019), ISRCTN15668391 (23 May 2019), ISRCTN18437550 (05/11/2021).https://doi.org/10.1186/s12981-025-00705-zCounsellingHIVAdvanced HIV DiseaseMeningitisUganda |
| spellingShingle | Alisat Sadiq Richard Kwizera Tadeo K Kiiza Peruth Ayebare Cynthia Ahimbisibwe Jane Frances Ndyetukira David R Boulware David B. Meya Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda AIDS Research and Therapy Counselling HIV Advanced HIV Disease Meningitis Uganda |
| title | Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda |
| title_full | Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda |
| title_fullStr | Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda |
| title_full_unstemmed | Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda |
| title_short | Experiences, challenges, gaps, and strategies for counselling persons presenting with advanced HIV-associated meningitis in Uganda |
| title_sort | experiences challenges gaps and strategies for counselling persons presenting with advanced hiv associated meningitis in uganda |
| topic | Counselling HIV Advanced HIV Disease Meningitis Uganda |
| url | https://doi.org/10.1186/s12981-025-00705-z |
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