Factors affecting utilization of sexual and reproductive health services for HIV-positive adolescents in care; case study: Masaka district

Abstract

Background: Adolescents are people between 10 – 19 years. Today, they constitute 20% of the world’s population according to World Health Organization. During this stage, adolescents go through a number of social, physical, emotional and psychological changes among which is sexual maturity, their desire for sex and relationships increases as a result. Among HIV positive adolescents the consequences of sex and relationships are more disastrous since they are more vulnerable. Access to sexual and reproductive health services is also still poor especially among the adolescents living with HIV/AIDS because of a number of reasons ranging from denial, living positively, adherence to drugs and living a healthy sexual and reproductive health life. However these consequences can be prevented with proper access and utilization of sexual and reproductive health services. Objective: The aim of this study was to assess the factors affecting access and utilization of SRH services by HIV+ adolescents receiving care in HIV care centres in Masaka district. Methodology: This was a descriptive cross-sectional study that was both qualitative and quantitative using structured questionnaire, focus group discussion and key informant interviews to collect data. The study was carried out in Masaka involving 277 respondents from two private and two public HIV care centres that were chosen by simple random sampling. The data was analyzed using statistical package for social sciences versions 21.0 and results were presented in proportions and frequency tables. Results: Almost all the respondents had knowledge about sexual and reproductive health services and among them were STI/HIV/AIDS screening and treatment, sexual education, family planning and counselling. These services were mainly given by clinicians and counsellors. Access to SRH services was also high with counselling, sexual education, STI/HIV/AIDS screening and treatment as the SRH services mainly accessed. The major factors affecting access were Knowledge about SRH, distance, SRH attitudes, and influence by peers, family and partners. Stigma and clinic setup, peer pressure, youth friendly centres, poor attendance and attitudes were the factors affecting utilization of SRH services. Policies guiding the provision of SRH services are not followed sufficiently in offering of these services. Factors affecting adherence to policies or measures that guide provision of SRH services included; awareness about policies, availability and accessibility to policies and lack of skilled personnel. Conclusions: Among HIV+ adolescents, there is a high level of access and utilisation of SRH services. A number of factors that affect access include; knowledge, attitudes, influence from peers, family and parents, and distance. Utilization was mainly affected by peer pressure, stigma and clinic setup, poor attendance, youth friendly centres among others. Policies in place to guide provision of SRH services are not sufficiently followed due to lack of awareness about policy, availability, accessibility and skilled personnel.