Introduction: In Sub-Saharan Africa, there are knowledge gaps on adverse drug reactions (ADRs) of antiretroviral treatment (ART). Studies have shown that limited training capacity among healthcare workers has affected reporting of ADRs and weakened the pharmacovigilance system in Tanzania. Studies have shown that the use of digital tools, including SMS communication, might be a viable way to increase knowledge and understanding of reporting ADRs. This study aimed to examine the acceptability and feasibility of SMS texts to increase awareness about the importance of reporting ADRs of ART among people living with HIV (PLHIV) in Tanzania. We also explored different ADR profiles that were reported by the participants. Methodology: This was a prospective implementation pilot study. PLHIV who consented to the study received a biweekly message to ask them how they were doing. We programmed keywords in the system that could be used for responding to the presence of ADR. The response to messages generated a flow of SMS that determined the presence of ADRs and informed participants to report. The technical feasibility was calculated based on the percentages of SMS which were sent and delivered about ADR and acceptability was measured based on the percentage of SMS that was replied to by the participants. We also collected data on different types of ADR reported by the participants. We conducted focus group discussions with participants and in-depth interviews with health workers to understand their experiences with and acceptability of the system. Results: Over a 12-month study period, a total of 92 participants were recruited. Sixty-two (67.4%) were women. The mean age of our participants was 42 years (SD 12). Forty (43.5%) participants were on ART for less than 3 months and the other 52 (56.5%) participants were on first-line ART. The system successfully sent and delivered 105 follow-up messages to all participants who consented to receive SMS. Among all the sent SMS 100 (95.2%) were replied to by the participants. Commonly reported ADRs were itching, gastrointestinal discomfort, joint pain, malaise and headache. The themes identified through FGD and IDI were: high motivation to report ADR, well-understood SMS content, the system to remain the same, no concerns about unwanted disclosure, and difficulties in replying to SMS due to network. The latter was mentioned by a few participants. Conclusion: SMS for creating awareness on ADRs reporting is a user-friendly intervention and highly accepted based on qualitative data among PLHIV in Tanzania. Also use of SMS is a low-cost intervention and a simple way to improve public health issues with society. Keywords: Short Message Services; Adverse drug reactions; Awareness; Acceptability

Background: In Tanzania, disclosure of HIV status to children remains a challenge despite the World Health Organization (WHO) recommendation that children should be informed about their HIV status between the ages of 6 to 12 years. This study aims to determine HIV status disclosure and related factors among children living with HIV in Kilimanjaro, Tanzania. Method: A cross-sectional study using a convergent parallel mixed-methods design was conducted from September 2021 to February 2022 among children aged 6-14 years receiving HIV care. Semi-structured questionnaires were collected from caregivers of undisclosed children, including socio-demographic data and reasons for non-disclosure. Additionally, we interviewed 20 caregivers of children in-depth who had disclosed and not disclosed the status to their children; we also interviewed children whose HIV status had been disclosed, followed by a focus group discussion. Bivariate and multivariate logistic regression analyses identified factors associated with HIV status disclosure. P<0.05 was considered statistically significant. We did thematic content analysis for qualitative data. Results: 121 children and their parents or caregivers were included in the analysis and 51(42%) knew about their HIV status. 31%(n=38) of children were between the ages 6-8 and among them, 33(87%) did not know about their status. Thirty-nine percent (n=47) of children were between the ages of 9-11; 32(68%) did not know about their status. 30% (n=36) of the children were above 12 years old, and 5(14%) did not know their status. 60 children were girls (49.5%); the majority (n=75;62%) lived with their biological parents; 112 children had primary education (93%); and 94 (78%) children attended referral hospitals for ART services. Moreover, 86(71%) of the children had caregivers who had been interviewed. In the final multivariate model, children aged above 12 years (OR= 30; 95%; Cl= 7.2-124); children aged 9-11(OR=2.7;95%; CI= 0.8-9.0) and having a treatment supporter (OR=2.9; 95%CI=1.0-8.2) were significantly associated with HIV status disclosure to their children compared to their counterparts respectively. Through IDI, we revealed the following themes: (1) HIV disclosure challenges and reasons not to disclose the status, (2) the process of the disclosure, and (3) the Importance of disclosure. Conclusion: HIV status disclosure to children living with HIV in Kilimanjaro region was associated with age above 12 years and having a treatment supporter, unlike the WHO recommendation. Therefore, health facilities should introduce new strategies to ensure children know their HIV status.

No abstract