Browsing by Author "Ssembajja, Fatuma"

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    Adherence to Antiretroviral Therapy in Jinja, Uganda: A Six-Year Follow-Up Study
    (PLoS ONE, 2013) Mbonye, Martin; Seeley, Janet; Ssembajja, Fatuma; Birungi, Josephine; Jaffar, Shabbar
    Introduction: We report on the adherence experience of a group of people living with HIV on ART over six years in Uganda. Methods: Between 2005 and 2009, we followed up 41 participants who were also part of a clinical trial comparing home and facility based delivery of ART in Jinja, eastern Uganda. We conducted qualitative in-depth interviews at enrolment, 3, 6, 18 and 30 months to capture experiences with adherence over time. In 2011 we returned to these participants to find out how they were fairing with long term adherence. We managed to retrace 24 participants and interviewed them about their experience. We thematically analysed the data and compared findings over time. Results: Initially there were few barriers to adherence and many followed the adherence guidance closely. By year six, relaxation of these rules was noticeable although self-reported adherence continued to be high. Alcohol consumption was more common than before. Some relatives of the participants who had died claimed that some deaths were a result of alcohol. While participants reported that ART had allowed them to reclaim independence and return to work the changes in work and social routines created new challenges for adherence. Side effects like lipodystrophy were not only causing some stigma but for some tested their faith in the drugs. Many participants reported resumption of sexual lives but apart from those who selected same status partners, disclosure to new partners was minimal. Conclusion: Good adherence practice to ART wanes over the long-term, and people who may have disclosed at initiation find it difficult to do so to new partners once they are healthy. Further adherence interventions and support with disclosure over the course of therapy may need to be considered. (Words: 283)
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    Gender, land and responses to health and environmental shocks in rural South Western Uganda
    (Journal of Gender, Agriculture and Food Security, 2017) Rutakumwa, Rwamahe; Pain, Adam; Bukenya, Dominic; Tumwekwase, Grace; Ssembajja, Fatuma; Seeley, Janet
    We examine the gendered responses to shocks – including HIV-related illness and death, and environmental factors such as drought or too much rain – and how women in south western Uganda navigate structural barriers such as the gender constraints in land ownership, to cope with the impact of shocks. The study is based on data drawn from households selected from a General Population Cohort of 20,000 people in Kalungu District. As part of a larger study investigating the impact of HIV on agricultural livelihoods, 22 households were purposively sampled for a qualitative study. These households were stratified by sex of household head and by a death having occurred/not occurred of an HIV-positive individual in the household. Our findings show the gendered dimensions in household responses to crises are shaped by women and men’s position in the social structure in general and within their families and households. Women can make effective use of their social relations to obtain material support and information to improve their family’s livelihood.