Disclosure of Their Status to Youth with Human Immunodeficiency Virus Infection in the Dominican Republic: A Mixed-Methods Study

Beck-Sagué, Consuelo M.; Pinzón-Iregui, María C.; Abreu-Pérez, Rosa; Lerebours-Nadal, Leonel; Navarro, Christi M.; Ibáñez, Gladys; Soto, Solange; Halpern, Mimi; Nicholas, Stephen W.; Malow, Robert M.; Dévieux, Jessy G.

doi:10.1007/s10461-014-0888-7

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…A possible reason for this low rate of the disclosure may be because most of the children that took part in this study were younger as observed with a mean age of ten years. Though this rate of disclosure is low, it is higher than those reported in Kenya, the Dominican Republic, Zimbabwe, and Ghana, 23,47,48,49 which ranged between 21% and 33%.…”

Section: Discussioncontrasting

confidence: 54%

“…Hence caregivers felt the need to refrain from disclosing until their child was old enough to understand such information before they could be told their status. Previous studies have reported that caregivers preferred to disclose to older adolescents than younger children 23,49,50 . Beck‐Sagué and colleagues 49 found among Dominicans that caregivers of younger children did not disclose their status because they felt their child had not reached the stage where they could understand and cope effectively with their condition.…”

Section: Discussionmentioning

confidence: 99%

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To disclose or not to disclose? Caregivers experiences of disclosure of HIV status of children living with HIV in Accra, Ghana

2021

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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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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

To disclose or not to disclose? Caregivers experiences of disclosure of HIV status of children living with HIV in Accra, Ghana

2021

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“…Findings showed that the rate of full disclosure of status to children living with HIV is still low in Ghana. Although this rate of disclosure is considered to be low, it is slightly higher compared to those reported in Kenya [ 31 ], the Dominican Republic [ 29 ], Zimbabwe [ 32 ], and earlier figures reported in Ghana [ 15 ]. The low rate of disclosure of HIV status could be attributed to the fact that the majority of the children who participated in this study were younger, and it has been established that older children and adolescents are more likely to have their HIV status disclosed to them than younger children [ 15 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 55%

Disclosure and health-related outcomes among children living with HIV and their caregivers

2021

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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.

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“…Although more than half of disclosures were led by children’s family members, accidental disclosures by friends and other persons were also reported, which requires further attention. As a previous study pointed out [ 26 ], accidental disclosure might be a more stressful event for children than that by their caregivers and/or health care workers, and it would have negative impact on them contrary to the prepared disclosure process.…”

Section: Discussionmentioning

confidence: 99%

Disclosure to HIV-seropositive children in rural Zambia

et al. 2018

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BackgroundCare of children living with HIV comprises various issues, some considered challenging. One of the challenging areas is the serostatus disclosure to HIV-positive children. This study describes the current situation of HIV disclosure among rural children in Zambia and examines the socio-demographic factors promoting disclosure.MethodsWe used a mixed method approach applying both quantitative and qualitative methods to obtain comprehensive picture of HIV serostatus disclosure for children. Data were collected in Mumbwa district, Zambia (2010–2012), included 57 clinical records of children older than 5 years old. We examined children’s age, gender, and cohabitation status with their parents, caregivers’ level of education and income, and the relation between children and caregivers. Logistic regression model was applied to examine associations between disclosure and socio-demographic characteristics. Semi-structured interviews with 50 caregivers and 22 HIV-positive children were conducted to qualitatively investigate attitude towards disclosure and support needed.ResultsFull disclosure was completed in 17 out of 57 (29.8%) patients. Median ages of patients in disclosed group and non-disclosed group were 10 and 9, respectively (IQR 8.0–13.0, 7.0–11.25). In univariate analyses, older age and male gender has positive relation to the completion of serostatus disclosure. In logistic regression models, cohabitation status with patients’ mothers showed positive correlation to the completion of serostatus disclosure. In the interviews with caregivers, all caregivers said that disclosure of serostatus is a necessary process and good for their children, while actual serostatus disclosure rate was low.ConclusionSerostatus disclosure to HIV-seropositive children is not prevalent in Rural Zambia. Although further researches would be desirable, increased support to caregivers would be beneficial.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1252-2) contains supplementary material, which is available to authorized users.

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Disclosure of Their Status to Youth with Human Immunodeficiency Virus Infection in the Dominican Republic: A Mixed-Methods Study

Cited by 12 publications

References 19 publications

To disclose or not to disclose? Caregivers experiences of disclosure of HIV status of children living with HIV in Accra, Ghana

To disclose or not to disclose? Caregivers experiences of disclosure of HIV status of children living with HIV in Accra, Ghana

Disclosure and health-related outcomes among children living with HIV and their caregivers

Disclosure to HIV-seropositive children in rural Zambia

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