Child behaviour and parenting in HIV/AIDS-affected families in China

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) among families in China poses many challenges for caregivers and their children. A total of 154 caregivers of HIV/AIDS-affected children were interviewed to examine child behaviour in HIV/AIDS-affected families. Parenting skills were found to be correlated with child delinquency, and this correlation was influenced by the number of children in the family and the child's age. Illiterate caregivers were more likely to have delinquent children, and parenting skills had less of an association with child delinquency among illiterate caregivers. Study findings underscore the necessity of emphasizing good parenting skills in interventions with caregivers of HIV/AIDS-affected children in China in order to improve child behaviour and overall family well-being.     

Disclosure of parental HIV/AIDS to children in rural China

Abstract

The purpose of this study is to examine the complex issue of disclosure of parental HIV/AIDS to children in rural China. Semi-structured interviews were conducted with children affected by HIV/AIDS aged 8–17 (n?=?16), their caregivers (n?=?16) and key informants in the community (n?=?5). Findings showed that most children were shielded from knowing the HIV/AIDS status of their parents, although many children may have drawn their own conclusions through observation or sources outside the family. Caregivers felt discouraged and hesitated to discuss parental HIV/AIDS with children due to societal stigma and lack of knowledge and skills. Interventions are needed to improve caregivers' skills to communicate about HIV/AIDS with children. Interventions are also needed to reduce the stigma and discrimination towards people living with HIV/AIDS and their families.     

艾滋病对贫困农村地区儿童监护人及家庭的影响研究

目的了解安徽省农村地区受艾滋病影响儿童监护人的情况,为今后开展干预活动提供基线资料。方法采用整群抽样方法,在安徽省阜南县抽取两个艾滋病流行重点村,招募所有符合条件的受艾滋病影响儿童的监护人,用半结构式问卷和面对面访谈方法进行调查。结果在154名调查对象中,女性占58%,年龄在36～45岁占70%,未上过学占48%,已婚占77%,全部是农民,家庭收入≤2500元的占54%。有53%的人将自己或家人的感染状况告诉了别人,81%的人告知了孩子。有54%的人认为自己的生活状况“差”或“很差”,45%的人对自己的健康状况不太满意,世界卫生组织生命质量指数平均为66.70,该指数同家庭艾滋病感染状况有关（F=9.40,P〈0.01）。女性Zung抑郁分值是25.61,男性23.14,女性明显高于男性（F=9.40,P〈0.01）;抑郁分值同家庭艾滋病感染情况有关（F=5.82,P〈0.01）。有14%的人认为艾滋病使得他们的家庭关系变差了,9%的人认为艾滋病使得他们的家庭关系变好了;有39%的人说曾遇到过歧视。所有监护人都赞同调查表中提出的干预活动,补充的建议中只涉及帮助改善经济状况和孩子的教育两个方面。结论在安徽省阜南县贫困农村地区,对受艾滋病影响儿童的监护人的影响主要包括：经济状况、健康状况、生活质量、家庭生活等方面,存在的需求是多方面的,但他们的主观要求并不高。     

Emotional Development and Nutritional Status of HIV/AIDS Orphaned Children Aged 6–12 Years Old in Thailand

Objective To explore the emotional development and nutritional status of HIV/AIDS orphans by their infection status. Methods A community-based cross-sectional survey was conducted during January and December 2005 in four provinces and Bangkok Metropolis where the prevalence of HIV/AIDS among pregnant women was high. The study population consisted of 388 HIV/AIDS orphans who were maternal or paternal or double orphans aged 6–12 years old. The orphans’ main caregivers gave informed consent to the project and assessed the emotional development of their orphaned children. The children were measured for weight, height, and emotional development by standard instruments. They were divided into three groups regarding their HIV/AIDS infection status reported by their caregivers: infected, non-infected, and unknown. The χ² test was used to determine the association between nutritional status and infection status. Results Regarding HIV/AIDS infected children, 19.1% were infected, 57.5% were not infected, and 23.4% were unknown. The main caregivers of all types of orphans were grandparents. Only 13.7% of infected orphans lived with their mothers. Most caregivers were females and more than 40 years old. Infected orphans had mean scores of overall emotional development and for each domain less than other groups. The mean scores of self-control and quick recovery were significantly different between infected and non-infected groups (P-value < 0.05). Nearly 50% of infected orphans were rather short and approximately 42% were under weight and light. The findings revealed a significant association between height for age, weight for age and infection status of orphans at a P-value of <0.001. Conclusions Orphanhood itself is a vulnerable status and HIV/AIDS infected orphans are most vulnerable. Acceptable and friendly services for orphans and their families are crucial. The services should continue and protect stigmatization.     

Household and community HIV/AIDS status and child malnutrition in sub-Saharan Africa: evidence from the demographic and health surveys

This paper examines the extent to which under five children in households or communities adversely affected by HIV/AIDS are disadvantaged, in comparison with other children in less affected households/communities. The study is based on secondary analysis of the Demographic and Health Survey (DHS) data collected during 2003-2008 from 18 countries in sub-Saharan Africa, where the DHS has included HIV test data for adults of reproductive age. We apply multilevel logistic regression models that take into account the effect of contextual community/country level HIV/AIDS factors on child malnutrition. The outcome variable of interest is child undernutrition: stunting, wasting and underweight. The results suggest that across countries in sub-Saharan Africa, children whose mothers are infected with HIV are significantly more likely to be stunted, wasted or underweight compared to their counterparts of similar demographic and socio-economic background whose mothers are not infected. However, the nutritional status of children who are paternal orphans or in households where other adults are HIV positive are not significantly different from non-orphaned children or those in households where no adult is infected with HIV. Other adult household members being HIV positive is, however, associated with higher malnutrition among younger children below the age of one. Further analysis reveals that the effect of mothers' HIV status on child nutritional status (underweight) varies significantly across communities within countries, the effect being lower in communities with generally higher levels of malnutrition. Overall, the findings have important implications for policy and programme efforts towards improved integration of HIV/AIDS and child nutrition services in affected communities and other sub-groups of the population made vulnerable by HIV/AIDS. In particular, children whose mothers are infected with HIV deserve special attention.     

Family caregiving for AIDS patients in the Democratic Republic of Congo

We conducted a qualitative study of women who were caregivers for HIV/AIDS-affected spouses in Bumbu Zone, Kinshasa, Democratic Republic of Congo in 2003. Twelve caregiving women, six home-based care workers and five key informants were interviewed via focus group discussions. Most women reported huge problems in providing care to their spouses due to psychological, social and economic factors. The secrecy around HIV/AIDS issues and care was a significant theme in the findings. The self-reported health status of the caregivers indicated poor health.     

Network stigma towards people living with HIV/AIDS and their caregivers: An egocentric network study

HIV stigma occurs among peers in social networks. However, the features of social networks that drive HIV stigma are not well understood. The objective of this study is to investigate anticipated HIV stigma within the social networks of people living with HIV/AIDS (PLWHA) (N = 147) and the social networks of PLWHA's caregivers (N = 148). The egocentric social network data were collected in Guangxi, China. More than half of PLWHA (58%) and their caregivers (53%) anticipated HIV stigma from their network peers. Both PLWHA and their caregivers anticipated that spouses or other family members were less likely to stigmatise them, compared to friend peers or other relationships. Married network peers were believed to stigmatise caregivers more than unmarried peers. The association between frequent contacts and anticipated stigma was negative among caregivers. Being in a close relationship with PLWHA or caregivers (e.g., a spouse or other family member) was associated with less anticipated stigma. Lower network density was associated with higher anticipated stigma among PLWHA's alters, but not among caregivers' alters. Findings may shed light on innovative stigma reduction interventions at the social network level and therefore improve HIV/AIDS treatment utilisation.     

Children caring for their ill parents with HIV/AIDS

Abstract

Children orphaned by HIV/AIDS experience not only the trauma of a parent's death, but the stress of living with and often caring for an ill and dying parent. We interviewed 50 mothers ill from HIV/AIDS in both Mutare, Zimbabwe and New York, USA, and one child of each aged 8–16 about personal assistive care the child provided; other household responsibilities; hours/day children spent on chores; and parental/child mental health. Children provided substantial amounts of personal care; took responsibility for cooking, cleaning, shopping and other household tasks; and some were their parents' confidants. The amount of care provided was related to maternal disability, not child age, gender, or presence of other adults/siblings. Children reported performing more tasks than their mothers reported. Almost half of New York and 80% of Mutare children said they had too much responsibility, and most reported reduced after-school and peer activities. Both children and parents felt children were more capable because of their responsibilities. Depression rates in New York and Mutare children were high but Mutare children were extremely vulnerable; two-thirds had depression scores in the clinically significant range. However, child caregiving was unrelated to depression. Research to better understand the role of child caregivers is still needed.     

受艾滋病影响儿童生长发育和社会心理健康状况调查

目的了解受艾滋病影响儿童生长发育及社会心理健康状况,为开展受艾滋病影响儿童健康促进干预工作提供参考依据。方法采用整群抽样方法,选取艾滋病高发乡镇全部受艾滋病影响儿童为暴露组,同班其他同学为对照组。调查主要内容包括身高、体重、家庭一般情况、社会心理状况等,采用SPSS11.0进行χ2检验。结果调查受艾滋病影响儿童(暴露组)70人,其中父母亲均HIV阳性者21人(30.0%),父母单HIV阳性47人(67.2%)、其他2人(2.9%)。对照组120人,家中均无HIV阳性人员。暴露组年龄别身高、年龄别体重和身高别体重等生长发育评价指标低于均数减一个标准差的比例与对照组比较,差异无统计学意义。暴露组父母文化程度、健康状况远低于对照组,差异有统计学意义。暴露组有30.8%和65.6%的儿童要做农活和家务活,20.5%有缺课现象,30.0%平时表现好,40.9%对目前生活状况满意,53.7%的儿童认为自己性格外向,与对照组比较差异有统计学意义。结论对于受艾滋病影响儿童的支持和干预,不仅要解决受艾滋病影响儿童的教育、医疗、生活等问题,而且要提供经济上、心理上的支持和帮助,更需要解决受艾滋病影响儿童的现实生活问题,如承担了与年龄和生长发育不相符的家务劳动和田间劳动等,应从社区、学校、家庭和个体支持多方面入手,实施干预措施应着眼于家庭,以现实条件为基础,为儿童提供支持性的环境。     

西南两县13～17岁受艾滋病影响儿童心理状况分析

目的了解我国西南两县受艾滋病影响的儿童心理状况。方法采用典型抽样方法,在西南两县抽取了受艾滋病影响的13~17岁儿童100名,非受艾滋病影响的13~17岁儿童116名。使用儿童心理状况调查表进行入户调查。结果与非受艾滋病影响儿童相比,受艾滋病影响儿童心理状况普遍不良。在心理九维度中,差异有统计学意义的为情绪维度,受影响儿童平均分为2.39,非受影响儿童平均分为2.64。在具体问题中,觉得自己有时伤心得想哭的受艾滋病影响儿童的比例达61.0%,而非受艾滋病影响儿童为42.2% 不能让自己高兴起来的受影响儿童的比例为36.0%,非受艾滋病影响儿童为18.1% 认为＂我与其他人相处挺好＂的受艾滋病影响儿童的比例为87.0%,非受艾滋病影响儿童为95.7%。以上3个问题经检验差异有统计学意义。结论受艾滋病影响儿童的心理状况普遍不如非受艾滋病影响儿童好,主要表现为情绪不良、社会交往较差。     

Psychosocial Problems and Coping Patterns of HIV Seropositive Wives of Men with HIV/AIDS

Abstract

The sociocultural milieu provides HIV positive women with fewer resources and more role responsibilities. The present research aimed at studying the psychosocial problems encountered in living, post HIV infection, and the coping patterns adopted by HIV seropositive wives of men with HIV/AIDS. In the background of an exploratory research design, thirty (n = 30) HIV positive women, attending Counseling Clinics in Bangalore (South India), selected through purposive sampling, were assessed using an interview schedule and a standardized coping scale. Majority of the respondents were the primary caregivers for their infected spouse and/or children. Content analysis of the problems revealed increased financial difficulties; problems in child care and support; compromised help-seeking due to stigma; problems in sexual interactions and communication in their marital relationship; role strain in caregiving; gender discriminatory and inadequate care; and increased concerns about parenting efficacy, post HIV infection. Escape avoidance was the most preferred coping strategy adopted by them. Situating the illness in a socio-familial context is indicated, and implications for social work and mental health practice follow from the findings.     

The prevalence of grandmothers as primary caregivers in a poor pediatric population

In the wake of the HIV/AIDS and crack cocaine epidemics, poor urban communities face growing numbers of older adults, largely grandmothers, who have become surrogate parents to children orphaned by these epidemics. This study is the first in the United States to determine the prevalence of older surrogate parents among families registered at pediatric clinics. The three clinics selected were in low income neighborhoods of New York City with a high incidence of female HIV/AIDS and substance abuse. Using a 50% random sample of 1,375 records of registered families, data were obtained on the number and ages of relatives serving as surrogate parents. In 11% of these 1,375 families with children 12 years and under a parent was not the caregiver. In 8% the caregiver was a grandmother. Forty-seven percent of these women were 55 years or older, 25% were 60 years or older and 8% were 70 years or older. Most of these women were caring for more than one child. Ten percent of the total of 2,445 children, 12 years and under, lived in non-parent headed families. Eight percent lived with a grandmother, 1% with other parental generation relatives and 1% in foster care. Given the stresses associated with caregiving in late life and the greater risk of poor health among low income African-American and Hispanic elderly, older surrogate parents from these communities are a potentially high health risk population whose own needs may go unrecognized and unattended. The young ages of the children suggest that many grandparents may continue to be caregivers as they reach their sixties, seventies and even eighties. Clinical and longitudinal data are needed to determine how prolonged surrogate parenting in late life affects the health of older caregivers and the children in their care. Coordination between health and social services for the elderly and for children are needed to promote effective programs for these families.     

Eating Competence Among Caregivers of Toddlers: Associations With Caregiver and Child Overweight/Obesity

ObjectiveTo examine the association between caregiver eating competence and child overweight/obesity and caregiver obesity.DesignLongitudinal cohort.SettingA large US children's hospital.ParticipantsCaregiver–child dyads (n = 288 with complete data at 2 time points) were sampled in 2017–2019 from those who received care at Nationwide Children's Hospital.Main Outcome Measure(s)Child overweight/obesity at 24 months of age (body mass index [BMI]) z-score >2 per World Health Organization standards and caregiver weight status (underweight/healthy [BMI < 25 kg/m²], overweight [BMI ≥ 25 and < 30 kg/m²], or obese [BMI ≥ 30 kg/m²]).AnalysisLog-binomial models examined the relationship between caregiver eating competence (ecSatter Inventory) at 18 months and child overweight/obesity at 24 months of age. Proportional odds models investigated the relationship between caregivers’ eating competence and weight status.ResultsEating competent caregivers had more than twice the odds (odds ratio, 2.11; 95% confidence interval, 1.30–3.42) of having a lower BMI category and had lower average BMI than noneating competent caregivers. Child overweight/obesity at 24 months did not differ by caregiver eating competence.Conclusions and ImplicationsAlthough child overweight/obesity did not vary by caregiver eating competence, caregiver eating competence was related to their weight status. Longer-term studies are needed to clarify the role of caregiver eating competence as children develop. Promoting caregivers’ eating competence may translate into healthier behaviors and skills for caregivers and their children long term.     

Healthcare Preferences of Lesbian, Gay, Bisexual, Transgender and Questioning Youth

BackgroundThroughout the developing world, children living on urban streets is a byproduct of economic deprivation. In Lahore, Pakistan, there are an estimated 5,000–7,000 street children.PurposeThe study examined HIV risk behaviors and factors associated with exchanging sex among male street children in Lahore, Pakistan.MethodsThe survey was conducted from August 2003 to March 2004 among 565 registrants, ages 5–19, of Project Smile, a program that aimed to enhance the lives of street children in Lahore. We analyzed the frequency of and correlates of recent (past 3 months) sex exchange for money, drugs, or goods. Multivariate log–binomial regression was used to evaluate the independent effect of covariates on exchange sex.ResultsApproximately 40% of participants reported having exchanged sex during the past 3 months. In multivariate analysis, the factors associated with exchanging sex were living on the street for longer than 48 months (Prevalence Ratio [PR]=1.36, 95% Confidence Interval [CI]: 0.99–1.85), reporting ever having used drugs (PR=1.87, 1.10–3.16), cutting one's self (PR=1.66, 95% CI: 1.26–2.19), and having heard of HIV/AIDS (PR=1.36, 95% CI: 1.03–1.80) after adjusting for demographic and street life variables.ConclusionsWe found high rates of sex exchange among a sample of street children in Lahore, Pakistan. The finding that children who have heard about HIV/AIDS are more likely to exchange sex suggests that children at HIV risk talk about HIV, but accuracy of their conversations is unclear. Street children in Pakistan are in great need of HIV education and safe alternatives for generating income.     

Reliability of anthropometric measurements performed by community nutrition workers in a community-based pediatric growth-monitoring program in rural Rwanda

BackgroundIn Rwanda, the community-based growth-monitoring program is implemented via volunteer community nutrition workers. These volunteers are recruited from within their communities, and receive basic training prior to providing services. Utilizing local volunteers improves access to basic nutrition services, and allows the local health jurisdictions to use qualified health care staff more efficiently. In addition to concerns raised in regards to the accountability of unpaid workers, some question the relevance of the data that is collected. We carried out a nutritional survey in the catchment area of Ruli District Hospital to evaluate the reliability of the community nutrition workers’ measurements of anthropometric standards collected within the growth-monitoring framework.MethodsA nutritional survey was recently organized in the catchment area of the hospital in December 2006. The prevalence rates of malnutrition from the survey were compared with those from the existing community-based growth-monitoring program. Z-test was used to compare the prevalence rate of underweight from the survey with the prevalence rate determined by data collected from community nutrition workers. The concordance of children classified with moderate and severe underweight in each data set was determined by the coefficient Kappa of Cohen.ResultsOur findings show that the recent survey reported an overall underweight prevalence rate of 27.2%. Community data calculated a prevalence rate of 28.8% for the same population. The difference is not statistically significant (P = 0.294). Of 724 children evaluated, the survey and the community were in agreement in regards to 454 children classified in the category of good nutritional status, 143 children classified in moderate underweight and 11 children classified in the severe underweight category. The Kappa of Cohen coefficient of 0.636 indicates strong concordance between data sets.ConclusionAnthropometric measurements provided by the community are reliable. Information gathered from the community can be used for epidemiologic monitoring of malnutrition. To ensure continued reliability, health centers must provide sufficient and permanent training to community nutrition workers. In addition, continued access to essential materials used for measuring nutritional status and maintenance of these materials will be crucial to the program's ongoing success.     

Prevalence and Factors Affecting Discrimination Towards People Living With HIV/AIDS in Indonesia

ObjectivesThis study aimed to identify the behaviors associated with discrimination towards people living with HIV/AIDS (PLHA) in Indonesia and to determine the factors affecting discrimination.MethodsSecondary data from the 2017 Indonesia Demographic and Health Survey were analyzed using a cross-sectional design. Discrimination was assessed based on the questions (1) “Should children infected with HIV/AIDS be allowed to attend school with non-infected children?” and (2) “Would you buy fresh vegetables from a farmer or shopkeeper known to be infected with HIV/AIDS?” Multivariable logistic regression was used to determine the factors affecting discrimination, with adjusted odds ratio (aOR) and 95% confidence interval (CIs) used to show the strength, direction, and significance of the associations among factors.ResultsIn total, 68.9% of 21 838 individuals showed discrimination towards PLHA. The odds of discrimination were lower among women (aOR, 0.63; 95% CI, 0.55 to 0.71), rural dwellers (aOR, 0.81; 95% CI, 0.75 to 0.89), those who understood how HIV is transmitted from mother to child (aOR, 0.81; 95% CI, 0.73 to 0.89), and those who felt ashamed of their own family’s HIV status (aOR, 0.56; 95% CI, 0.52 to 0.61). The odds were higher among individuals who knew how to reduce the risk of getting HIV/AIDS (aOR, 1.27; 95% CI, 1.15 to 1.39), how HIV/AIDS is transmitted (aOR, 3.49; 95% CI, 3.09 to 3.95), and were willing to care for an infected relative (aOR, 2.78; 95% CI, 2.47 to 3.13). A model consisting of those variables explained 69% of the variance in discrimination.ConclusionsGender, residence, knowledge, and attitudes related to HIV/AIDS were explanatory factors for discrimination against PLHA. Improvements in HIV/AIDS education programs are needed to prevent discrimination.     

Attitudes of Thai caregivers of children with HIV infection towards HIV disclosure

Abstract

We sought to understand the attitude of caregivers of Thai children with HIV towards HIV disclosure by having 49 caregivers complete a disclosure questionnaire. Their children's median age was 6.9 years, with 55% being male. The children were all on antiretrovirals and had a median CD4 of 20%. None of the caregivers had disclosed to their child, and 37% did not intend to. The main reason for not disclosing was fear of causing the child psychological harm. Only 17% intended to tell the truth if asked by the child. Our caregivers are unprepared, have limited understanding about disclosure and are willing to lie to the child. There is a need to support Thai children and caregivers in disclosing HIV diagnosis.     

Prevalence of malnutrition in children under five and school-age children in Milot Valley,Haiti

ObjectivesThis research aims to provide child malnutrition prevalence data from Haiti's Milot Valley to inform the design and implementation of local health interventions.Study designThis cross-sectional study measured underweight, stunting, and wasting/thinness using international growth standards.MethodsAnthropometric measurements (height/length and weight) were taken on a convenience sample of 358 children aged 0–14 years. Participants were recruited through door-to-door field visits at five recruitment sites in the Milot Valley, including individuals in the waiting area of the Pediatric Outpatient Clinic at Hôpital Sacré Coeur. Caregivers were asked questions about the child's health history, including past and current feeding practices.ResultsCombining moderate and severe forms of malnutrition, 14.8% of children under five were stunted, 15.3% were wasted, and 16.1% were underweight. Among children 5–14 years of age, 14.1% were stunted, 7.6% were thin (low body mass index (BMI)-for-age), and 14.5% were underweight. For children under five, 42% of mothers ended exclusive breastfeeding before the recommended six months.ConclusionThis study illustrates the local magnitude of childhood malnutrition and can serve as a resource for future child health interventions in the Milot Valley. To fight malnutrition, a multipronged, integrated approach is recommended, combining effective community outreach and monitoring, inpatient and outpatient nutrition therapy, and expanded partnerships with nutrition-related organizations in the region.     

Pathways from parental AIDS to child psychological,educational and sexual risk: Developing an empirically-based interactive theoretical model

Increasing evidence demonstrates negative psychological, health, and developmental outcomes for children associated with parental HIV/AIDS illness and death. However, little is known about how parental AIDS leads to negative child outcomes. This study used a structural equation modelling approach to develop an empirically-based theoretical model of interactive relationships between parental or primary caregiver AIDS-illness, AIDS-orphanhood and predicted intervening factors associated with children's psychological distress, educational access and sexual health. Cross-sectional data were collected in 2009–2011, from 6002 children aged 10–17 years in three provinces of South Africa using stratified random sampling. Comparison groups included children orphaned by AIDS, orphaned by other causes and non-orphans, and children whose parents or primary caregivers were unwell with AIDS, unwell with other causes or healthy. Participants reported on psychological symptoms, educational access, and sexual health risks, as well as hypothesized sociodemographic and intervening factors. In order to build an interactive theoretical model of multiple child outcomes, multivariate regression and structural equation models were developed for each individual outcome, and then combined into an overall model. Neither AIDS-orphanhood nor parental AIDS-illness were directly associated with psychological distress, educational access, or sexual health. Instead, significant indirect effects of AIDS-orphanhood and parental AIDS-illness were obtained on all measured outcomes. Child psychological, educational and sexual health risks share a common set of intervening variables including parental disability, poverty, community violence, stigma, and child abuse that together comprise chain effects. In all models, parental AIDS-illness had stronger effects and more risk pathways than AIDS-orphanhood, especially via poverty and parental disability. AIDS-orphanhood and parental AIDS-illness impact child outcomes through multiple, interlinked pathways. The interactive model developed in this study suggests key areas of focus for interventions with AIDS-affected children.     

Access to and perceptions towards water,sanitation and hygiene: a case of HIV/AIDS affected and non-affected households in rural Uganda

Aim

To explore the water, sanitation and hygiene (WASH) access and perceptions among households with people living with HIV/AIDS (affected households) as compared to households without people living with HIV/AIDS (non-affected households).

Methods

This was a cross-sectional study that was conducted in the rural districts of Mpigi and Gomba. The study used a sample of 450 respondents with 222 from HIV/AIDS affected and 228 from HIV/AIDS non-affected households.

Results

Majority of respondents had improved water sources although most of these sources were beyond 2 km from households. Respondents from HIV/AIDS-affected households were four times more likely to have ever used a chemical water disinfectant locally known as “water guard”. Additionally, affected households were twice more likely to mention having clean containers for storing drinking water and twice more likely to report boiling water for drinking. No significant differences in presence of latrines for affected and non-affected households were reported. Households with a perception that fetching water takes a lot of time were more likely to buy water from vendors.

Conclusions

Access to improved water sources in short distances with a round trip water collection time of 30 min as recommended by WHO/UNICEF is still a challenge in this region. Good water practices were reported more in HIV/AIDS-affected households. A perception that fetching water takes a lot of time is significantly associated with buying water from vendors. Sleeping in own house is significantly associated with household presence of latrines.