Browsing by Author "Mary Abwola Olwedo"

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Bottlenecks and opportunities towards achieving the targeted 95-95-95 HIV services in a rural district in Eastern Uganda
(Health Services gateway, 2022-12-21) Monkya Samuel Namenkere; Ayaa Mary Stella; Sukuku Linda; Kharono Juliet; Mugabi Charles; Chelangat Benina; Mary Abwola Olwedo; Carol Nabasumba; Paul Oboth; Julius Osele; Rebecca Nekaka; Jacob Stanley Iramiot
Background: Uganda has made progress in reducing its HIV prevalence from 7.3% in 2011 to 6% in 2017, however, more needs to be done to meet the World Health Organization (WHO) target of 95% of the population knowing their HIV status, 95% enrolled on treatment and 95% achieving viral suppression. This study aimed to assess the bottlenecks and opportunities towards achieving the 95 95 95 targeted HIV services in the Bukedea district. Methods: A mixed-methods cross-sectional study was conducted in the Bukedea district covering males and females aged 18-65 years who had consented to participate in the study. We used a purposive sampling procedure to select our study participants. Qualitative data was collected through focus group discussions, key informant interviews, and document reviews for quantitative data. Quantitative data were analyzed using STATA v 14 whereas qualitative data were analyzed using the thematic analysis approach. Results: The challenges were grouped as patient-related, medication-related, and facility-related. The patient-related challenges were stigma, fear of taking the medication, poor nutrition, long distances, alcoholism, busy working schedules, and domestic violence. The medication-related challenges were side effects and pill burden. The facility-related challenges were inadequate pretest counseling and stock-outs. The use of anti-retroviral drugs (ART) was common in piggery and poultry and the sources of these drugs were reported to be the people on ART and the health workers. The opportunities included home-based counseling, organizing more outreaches, counseling and health education, targeted testing, and strengthening the Village Health Teams (VHT) networks. Conclusions: The study revealed that the major challenges towards achieving the targeted 95-95-95 HIV services were stigma, inadequate pre-test counseling, fear of disclosure, and poor adherence due to alcoholism, sharing of drugs with animals and partners. The use of anti-retroviral drugs in animal husbandry was common in the Bukedea District. Keywords enrolment to care, HIV testing, Viral load suppression, HIV infection, HAART, expert clients, HIV care, Adherence to HIV treatment.
Factors associated with modern contraceptive use among sexually active youths attending secondary schools in Mbale City, Uganda
(PLOS Global Public Health, 2025-10-03) Mary Abwola Olwedo; Nelson Bunani
Sexual and reproductive health of youths constitutes a significant public health challenge because of the high risk for morbidity and mortality. There is low uptake of modern contraceptives among the sexually active youths despite availability. We investigated the factors associated with the uptake of modern contraceptives among youths attending secondary schools in Mbale City. This was a cross-sectional study that enrolled 2,690 students from six purposively selected high-volume secondary schools in Mbale City. Data were collected using a validated semi-structured questionnaire and analyzed using descriptive statistics and multivariable logistic regression to identify factors associated with modern contraceptive use. The factors associated with modern contraceptive were stratified by sex. Statistical significance was set at 5% confidence level. Out of 2690 participants, 38.0% were sexually active. The proportion of sexually active participants who had ever used modern contraceptives was 60.9%. Factors associated with modern contraceptive use among male participants were not knowing the fertility days of the female (AOR = 0.49; 95% CI: 0.32-0.77; p = 0.002) and not receiving health education from a health worker (AOR = 0.44; 95% CI: 0.30-0.64; p < 0.001). Among females, factors associated with modern contraceptive use were knowledge of fertility days (AOR = 0.39; 95% CI: 0.18-0.85; p = 0.018), history of abortion (AOR = 0.10; 95% CI: 0.02-0.62; p = 0.014), and receiving health education from a health worker (AOR = 0.36; 95% CI: 0.22-0.59; p < 0.001). Modern contraceptive use was low compared to the national average, with knowledge of fertility days and health education significantly influencing uptake. Among males, lack of fertility knowledge and absence of health education were associated with low use of modern contraceptives. Among females, knowledge of fertility, history of abortion, and health education were key factors. Strengthening school-based sexuality education and increasing health worker-led reproductive health counselling can improve modern contraceptive knowledge and uptake, with gender-specific interventions needed to address barriers to access and use.
Factors associated with modern contraceptive use among sexually active youths attending secondary schools in Mbale City, Uganda
(PLOS, 2025-10-03) Mary Abwola Olwedo; Nelson Bunani
Sexual and reproductive health of youths constitutes a significant public health challenge because of the high risk for morbidity and mortality. There is low uptake of modern contraceptives among the sexually active youths despite availability. We investigated the factors associated with the uptake of modern contraceptives among youths attending secondary schools in Mbale City. This was a cross-sectional study that enrolled 2,690 students from six purposively selected high-volume secondary schools in Mbale City. Data were collected using a validated semi-structured questionnaire and analyzed using descriptive statistics and multivariable logistic regression to identify factors associated with modern contraceptive use. The factors associated with modern contraceptive were stratified by sex. Statistical significance was set at 5% confidence level. Out of 2690 participants, 38.0% were sexually active. The proportion of sexually active participants who had ever used modern contra ceptives was 60.9%. Factors associated with modern contraceptive use among male participants were not knowing the fertility days of the female (AOR = 0.49; 95% CI: 0.32-0.77; p = 0.002) and not receiving health education from a health worker (AOR = 0.44; 95% CI: 0.30-0.64; p < 0.001). Among females, factors associated with modern contraceptive use were knowledge of fertility days (AOR = 0.39; 95% CI: 0.18-0.85; p = 0.018), history of abortion (AOR = 0.10; 95% CI: 0.02-0.62; p = 0.014), and receiving health education from a health worker (AOR = 0.36; 95% CI: 0.22-0.59; p < 0.001). Modern contraceptive use was low compared to the national average, with knowledge of fertility days and health education significantly influencing uptake. Among males, lack of fertility knowledge and absence of health education were associated with low use of modern contraceptives. Among females, knowledge of fertility, history of abortion, and health education were key factors. Strengthening school-based sexuality education and increasing health worker-led reproductive health counselling can improve modern contraceptive knowledge and uptake, with gender-specific interventions needed to address barriers to access and use.
Prevalence and factors associated with mental health problems among adolescents living with HIV as screened by youth peers in rural Uganda: A cross-sectional study
(PLOS Global Public Health, 2026-04-29) Mary Abwola Olwedo; Simon Eleku; Emmanuel Ayikobua Tiyo; Richard Mpango; Alex Imalingat; Fred Kirya; Derrick Amone; Hellen Akurut; Nelson Bunani
Adolescents living with HIV face numerous psychosocial challenges that increase their vulnerability to mental health problems. However, limited evidence exists on the prev alence and contributing factors among this population in the Teso region of Uganda. This study assessed the prevalence of mental health problems and associated fac tors among adolescents living with HIV in the Teso region. A cross-sectional study was conducted among adolescents aged 10–19 years receiving HIV care in selected high-volume health facilities in the Teso region. Data were collected using the Home, Education/Employment, Activities, Drugs, Sexuality, Suicide/Depression psychosocial assessment tool (HEADSS tool), uploaded onto Kobo Collect for digital data collection. The data were exported to Microsoft Excel, cleaned, and analyzed using STATA version 17. Descriptive statistics were used to summarize sociodemo graphic characteristics and estimate the prevalence of mental health problems. Logistic regression analysis was used to identify factors associated with mental health prob lems. The prevalence of mental health problems was 35.2%, with suicidal tendencies being the most common (31%). Factors significantly associated with mental health problems included staying with one parent (AOR = 0.71; 95% CI: 0.55-0.92; p = 0.001) and not working (AOR = 4.4; 95% CI: 1.66–11.62; p = 0.03). Mental health problems are prevalent among adolescents living with HIV in the Teso region. Supportive living arrangements were protective, while employment was associated with increased risk. Peer-led screening can aid early identification, emphasizing the need to integrate men tal health services into adolescent HIV care, strengthen family and caregiver support
Second-line virologic failure and elevated bilirubin as a potential surrogate marker of ART adherence among people living with HIV in Eastern Uganda
(Springer Nature, 2026) Simiyu Melap Lynnet; Jacob Stanley Iramiot; Rebecca Nekaka; Patrick Okware; Mary Abwola Olwedo; Joshua Epuitai; Paul Oboth; Herbert Itabangi; Lydia V. N. Ssenyonga; Julius Nteziyaremye; David Okia
Second-line antiretroviral therapy (ART) failure remains a challenge in HIV Programs. We conducted a cross sectional study among people living with HIV on second-line ART in Eastern Uganda to determine the prevalence and associated factors of virological failure and to assess elevated serum bilirubin as a surrogate marker of adherence. The prevalence of virological failure was 7.5%. Elevated bilirubin showed poor sensitivity and specificity for predicting adherence or virological failure. The findings highlight the need for routine viral load monitoring, as bilirubin is not a reliable surrogate marker of treatment adherence or virological failure. Keywords Second-line virological failure, Elevated bilirubin, And adherence