Growing-up just like everyone else

Brandt, Laura; Beima‐Sofie, Kristin; Hamunime, Ndapewa; Shepard, Mark; L, Ferris; Ingo, Paulina; John‐Stewart, Grace; O’Malley, Gabrielle

doi:10.1097/qad.0000000000000667

Cited by 23 publications

(24 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, although HIV prevalence was relatively high in children tested in the parent study (7.4%[12]), caregivers can accurately be told that the chance that their child is negative greatly outweighs the chance that their child is infected. Caregivers and HCWs called for more hopeful language in counseling sessions about the probability of a negative child and the potential for children with HIV to live long healthy lives [27]. …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Brief Report: Disclosure, Consent, Opportunity Costs, and Inaccurate Risk Assessment Deter Pediatric HIV Testing: A Mixed-Methods Study

Wagner

O’Malley

Firdawsi

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background Prompt child HIV testing and treatment is critical; however, children are often not diagnosed until symptomatic. Understanding factors that influence pediatric HIV testing can inform strategies to increase testing. Methods A mixed-methods study was conducted at a tertiary hospital in Nairobi, Kenya. Three focus group discussions with health care workers (HCW) and 18 in-depth interviews with HIV-infected adults with children of unknown status were analyzed using thematic analysis. A structured questionnaire was administered to 116 HIV-infected caregivers of children of unknown status to triangulate qualitative findings. Results Analysis revealed 3 key periods of the pediatric HIV testing process: decision to test, test visit, and post-test. Key issues included: decision to test: inaccurate HIV risk perception for children, challenges with paternal consent, lack of caregiver HIV status disclosure to partners/older children; test experience: poor understanding of child consent/assent and disclosure guidelines, perceived costs of testing and care, school schedules, HCW discomfort with pediatric HIV testing; post-test: pessimism regarding HIV-infected children’s prognosis, caregiver concerns about own emotional health if child is positive, and challenges communicating about HIV with children. Concerns about all three periods influenced child testing decisions. Additionally, three challenges were unique to pediatric HIV: inaccurate HIV risk perception for children; disclosure, consent, and permission; and costs and scheduling. Conclusions Pediatric HIV testing barriers are distinct from adult barriers. Uptake of pediatric HIV testing may be enhanced by interventions to address misconceptions, disclosure services, psychosocial support addressing concerns unique to pediatric testing, child-focused HCW training, and alternative clinic hours.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Task shifting pediatric testing discussions to peer mentors—other adults who have tested their children—may be effective [28]. Disclosure remains delayed in many settings [29-32] and family disclosure interventions may complement pediatric testing scale-up [27, 33-37]. …”

Section: Discussionmentioning

confidence: 99%

Brief Report: Disclosure, Consent, Opportunity Costs, and Inaccurate Risk Assessment Deter Pediatric HIV Testing: A Mixed-Methods Study

Wagner

O’Malley

Firdawsi

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

show abstract

“…25,26 In this retrospective study, we evaluated the impact of the intervention on child knowledge of their HIV status, adherence to ART, and viral suppression, using the most complete routine service delivery data available.…”

Section: Introductionmentioning

confidence: 99%

Pediatric HIV Disclosure Intervention Improves Knowledge and Clinical Outcomes in HIV-Infected Children in Namibia

Beima‐Sofie

Brandt

Hamunime

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Objectives:Using routinely collected data, we evaluated a nationally implemented intervention to assist health care workers and caregivers with HIV disclosure to children. We assessed the impact of the intervention on child's knowledge and health outcomes.Methods:Data were abstracted from national databases and patient charts for HIV-infected children aged 7–15 years attending 4 high-volume HIV clinics in Namibia. Disclosure rates, time to disclosure, and HIV knowledge in 314 children participating in the intervention were analyzed. Logistic regression was used to identify correlates of partial vs. full disclosure. Paired t-tests and McNemar tests were used to compare adherence and viral load (VL) before versus after intervention enrollment.Results:Among children who participated in the disclosure intervention, 11% knew their HIV status at enrollment and an additional 38% reached full disclosure after enrollment. The average time to full disclosure was 2.5 years (interquartile range: 1.2–3 years). Children who achieved full disclosure were more likely to be older, have lower VLs, and have been enrolled in the intervention longer. Among children who reported incorrect knowledge regarding why they take their medicine, 83% showed improved knowledge after the intervention, defined as knowledge of HIV status or adopting intervention-specific language. On comparing 0–12 months before vs. 12–24 months after enrollment in the intervention, VL decreased by 0.5 log10 copies per milliliter (N = 42, P = 0.004), whereas mean adherence scores increased by 10% (N = 88, P value < 0.001).Conclusions:This HIV disclosure intervention demonstrated improved viral suppression, adherence, and HIV knowledge and should be considered for translation to other settings.

show abstract

“…Equally reporting on an ongoing study, Reynolds et al [37] presented the background, process and methods of a collaborative approach to develop and evaluate a paediatric HIV disclosure intervention in Ghana; challenges and implications are also reported. Brandt et al [38] undertook a qualitative study to identify the key components of a child-friendly ‘disclosure book’ to assist caregivers and healthcare workers in Namibia with paediatric HIV status disclosure. This tool was easy to implement and helped overcome barriers to disclosure by reducing caregiver resistance, increasing HIV and disclosure knowledge, and providing a gradual, structured disclosure framework [38].…”

mentioning

confidence: 99%

“…Brandt et al [38] undertook a qualitative study to identify the key components of a child-friendly ‘disclosure book’ to assist caregivers and healthcare workers in Namibia with paediatric HIV status disclosure. This tool was easy to implement and helped overcome barriers to disclosure by reducing caregiver resistance, increasing HIV and disclosure knowledge, and providing a gradual, structured disclosure framework [38]. …”

mentioning

confidence: 99%