` Uganda AIDS Commission Uganda HIV/AIDS Control Project (MAP) LQAS Monitoring Report Assessment of HIV/AIDS Related Knowledge, Practices and Coverage in 19 Districts of Uganda October-November 2003 Phyllis Joy Mukaire David Kaweesa Kisitu John B. Ssekamatte-Ssebuliba Joseph J. Valadez June 2004 Table of Contents LIST OF ACRONYMS ..........................................................................................................V ACKNOWLEDGEMENTS ................................................................................................. VI EXECUTIVE SUMMARY .....................................................................................................1 MAJOR FINDINGS ....................................................................................................................1 FOLLOW-UP STUDY RESULTS..................................................................................................3 CHAPTER 7 REPORTS FINDINGS OF THE DIAGNOSTIC STUDY WHICH MANAGERS SHOULD CONSIDER WHEN DESIGNING STRATEGIES FOR IMPROVING OR REDIRECTING THEIR PROGRAMS.BACKGROUND ......................................................................................................3 BACKGROUND.........................................................................................................................4 THE MULTI-COUNTRY AIDS PROJECT ...................................................................................4 DISTRICT VARIATIONS ............................................................................................................5 CHAPTER 1: FINDINGS FOR MEN 15-54.........................................................................6 VOLUNTARY COUNSELING AND TESTING ...............................................................................6 KNOWLEDGE OF MOTHER-TO-CHILD TRANSMISSION OF HIV/AIDS......................................7 KNOWLEDGE OF THE ABC’S OF HIV/AIDS PREVENTION AND KNOWLEDGE OF TREATMENT FOR STI’S ...............................................................................................................................8 MISCONCEPTIONS ABOUT HIV/AIDS ...................................................................................10 SELF-ASSESSMENT OF RISK ..................................................................................................11 CONDOM USE .......................................................................................................................12 CHAPTER 2: FINDINGS FOR WOMEN 15-49................................................................13 VOLUNTARY COUNSELING AND TESTING .............................................................................13 KNOWLEDGE OF MOTHER-TO-CHILD TRANSMISSION OF HIV/AIDS....................................14 KNOWLEDGE OF THE ABC’S OF HIV/AIDS PREVENTION AND KNOWLEDGE OF TREATMENT FOR STIS...............................................................................................................................14 MISCONCEPTIONS ABOUT HIV/AIDS ...................................................................................15 SELF-ASSESSMENT OF RISK ..................................................................................................16 CONDOM USE .......................................................................................................................17 CHAPTER 3: FINDINGS FOR MOTHERS OF CHILDREN 0-11.................................19 KNOWLEDGE OF MOTHER-TO-CHILD TRANSMISSION OF HIV/AIDS....................................19 USE OF ANTENATAL CARE SERVICES....................................................................................19 DELIVERY IN A HEALTH FACILITY ........................................................................................20 COUNSELING ON MTCT AND VCT.......................................................................................21 CHAPTER 4: FINDINGS FOR YOUNG PEOPLE 15-24 ................................................22 KNOWLEDGE OF THE ABC’S OF AIDS PREVENTION ............................................................22 SEXUAL BEHAVIOUR.............................................................................................................23 CORRECT USE OF CONDOMS .................................................................................................25 SELF-ASSESSMENT OF RISK AND MISCONCEPTIONS ABOUT TRANSMISSION .........................26 KNOWLEDGE OF SEXUALLY TRANSMITTED INFECTIONS AND OF MTCT ..............................27 LQAS Report October-November 2003 page ii CHAPTER 5: FINDINGS FOR ORPHANS 6-18...............................................................29 TYPES OF ORPHANS ..............................................................................................................29 EDUCATION...........................................................................................................................30 CARE AND SUPPORT..............................................................................................................32 MATERIAL SUPPORT..............................................................................................................32 CHAPTER 6: FINDINGS FOR PEOPLE LIVING WITH HIV/AIDS ...........................33 A PROFILE OF PLWHAS.......................................................................................................33 MEDICAL CARE FOR PLWHAS.............................................................................................34 OTHER TYPES OF CARE AND SUPPORT ..................................................................................35 POSITIVE LIVING PRACTICES ................................................................................................36 HARMFUL PRACTICES ...........................................................................................................37 MISCONCEPTIONS ABOUT HIV/AIDS ...................................................................................38 KNOWLEDGE OF THE ABCS OF HIV/AIDS PREVENTION AND CONDOM USE .......................38 CHAPTER 7: FINDINGS OF THE FOLLOW-UP STUDY.............................................40 PURPOSE OF THE FOLLOW-UP STUDY ...................................................................................40 FINDINGS ..............................................................................................................................41 Preventing MTCT.............................................................................................................41 PMTCT Facility Assessment............................................................................................45 TYPE AND LEVEL OF FACILITY ..............................................................................................46 CONDOM USE .......................................................................................................................49 VOLUNTARY COUNSELING AND TESTING .............................................................................56 PEOPLE LIVING WITH HIV/AIDS..........................................................................................61 PLWHA Service Facility Assessment...............................................................................64 ORPHAN CARE AND SUPPORT ...............................................................................................67 COMMUNITY LEVEL HIV/AIDS EDUCATION AND PROMOTION............................................68 METHODS .............................................................................................................................70 Study Area........................................................................................................................70 Capacity to Undertake the Study .....................................................................................70 Study Methods and Target Groups ..................................................................................70 Facility Assessment..........................................................................................................71 Key Informant Interviews.................................................................................................71 Focus Group Discussions ................................................................................................71 Document Review.............................................................................................................72 CHAPTER 8: LQAS PRINCIPLE AND METHOD..........................................................73 PRINCIPLES ...........................................................................................................................73 METHODS .............................................................................................................................75 The Sample.......................................................................................................................75 Sampling at the District Level..........................................................................................75 SELECTING AND TRAINING INTERVIEWERS ...........................................................................76 Training............................................................................................................................77 DATA COLLECTION...............................................................................................................77 DATA ANALYSIS ...................................................................................................................80