Background The prevalence of disclosure of status to children living with the Human Immunodeficiency Virus (HIV) is low in most sub-Saharan African countries, leading to poor compliance and adverse psychological outcomes in these children. This study examined the influence of disclosure on health outcomes in children living with HIV and their caregivers. Methods Using a cross-sectional design, 155 HIV-positive children between age 6–15 years and their caregivers were administered standardized questionnaires measuring adherence to medication, children's psychological well-being, caregiver burden, and caregivers’ psychological health. Results Results indicated that only 33.5% of the children sampled knew their status. Disclosure of HIV status was significantly related to medication adherence, psychological wellbeing, the burden of caregiving, and the length of the disclosure. A child’s age and level of education were the only demographic variables that significantly predicted disclosure of HIV status. In a hierarchical analysis, after controlling for all demographic variables medication adherence, psychological well-being and burden of caregiving were found to be significant predictors of disclosure of status in children living with HIV. Conclusions Findings suggest the need for disclosure of status among children living with HIV for a positive impact on their medication adherence and psychological health. These findings underscore the need for the development of context-specific interventions that will guide and encourage disclosure of status by caregivers to children living with HIV.
Background Status disclosure remains a major challenge for most caregivers of children living with HIV/AIDS, and it remains suboptimal, resulting in reduced adherence and negative psychological and physical outcomes in these children. This study explored caregivers’ experiences of disclosure of the HIV status of their affected children within the Greater Accra Region of Ghana. Methods Using the interpretive phenomenological qualitative approach, in‐depth interviews were conducted among 15 caregivers (aged 27–55 years) who were either the biological parents or guardians of children living with HIV (aged 6–15 years) from three main hospitals giving antiretroviral care in the Greater Accra Region. Interviews focused on the reasons for disclosure, the process of disclosure, and the aftermaths of disclosure. The interviews were recorded, transcribed, and subsequently analyzed thematically. Results Three main themes emerged from the analysis: “The Despair of HIV Diagnosis,” “The Dilemma and Nuances of Disclosure,” and “Aftermaths of Disclosure” Generally, the diagnosis of HIV in the children came as a shock to most caregivers which led to subsequent testing and diagnosis of caregivers. Two forms of disclosure were observed from the narratives: partial and full disclosure. Reasons for full disclosure were the child's curiosity, non‐adherence to antiretroviral therapy, and transition to high school. Non‐disclosure was as a result of stigma, the child been too young, and a lack of skill to disclose. Overall, caregivers reported that disclosure improved adherence and well‐being in their children; and helped reduce tension and anxiety among caregivers. Conclusions These findings suggest disclosure of HIV status to children living with HIV/AIDS has the potential to positively influence health outcomes in these children. However, caregivers need to be educated to initiate disclosure with the needed assistance from health care providers.
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