Healthcare Providers' Perspectives on Discussing HIV Status with Infected Children

Myer, Landon; Moodley, Keymanthri; Hendricks, Fahad; Cotton, Mark

doi:10.1093/tropej/fml004

Cited by 73 publications

(115 citation statements)

References 6 publications

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“…This is similar to the thoughts of the care takers who suggested that specific discussions regarding HIV infection should be delayed to a median of 10 years. 10 It is also in agreement with the theory of child's cognitive understanding of illness, which considers the age from 9 to 10 years and older as the best time for HIV infected children to know about their sickness as at this age children can understand about causes of illness and its consequences. 28 Attending the psycho social support group was significantly associated with disclosure and this could be because caretakers share their experiences and lessons learnt, including passing of information on HIV to children.…”

supporting

confidence: 82%

“…7 The challenges of disclosure include concerns that the child might be psychologically harmed or may not keep the secret 8 and fear that the stigma of AIDS will have a negative impact on their children and families Weiner et al 9 Although sub Saharan Africa has one of the highest numbers of children with HIV, disclosure of HIV status to infected children has received relatively little attention. 10 With a high burden of HIV in children, disclosure is an issue that families, practitioners, and researchers need to address. 5 As an increasing number of children born infected with HIV live to older ages, the question of when and how to talk with them about their HIV status becomes more crucial.…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting disclosure of serostatus to children attending Jinja Hospital Paediatric HIV clinic, Uganda

Namasopo-Oleja¹,

Bagenda²,

Ekirapa-Kiracho³

2015

Afr H. Sci.

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Abstract:Background: Disclosure of HIV status is important for optimal adherence to antiretroviral therapy in children. Identifying factors that affect disclosure of sero-status to children will help improve the process of disclosure. The purpose of the study was to determine the rate of HIV disclosure by the parents/caretakers to their children and other factors affecting disclosure. Methods: A cross sectional study among 174 caretakers of children age 5-18 years, twenty children and all (ten) health workers at Jinja Hospital paediatric HIV clinic. Data was collected with standardized questionnaires on socio-demographic factors, disclosure status, health facility factors, fears and perceived benefits of disclosure. Results: We found disclosure rates in 56% of the children. Among those not disclosed to, non-disclosure was 19% and deception 25%. Factors associated with disclosure of sero-status to a child were age of child (X2 37.4 df 1 p< 0.001), child being on antiretroviral therapy (OR 2.0 CI 1.1-3.6 p=0.024) and child attending psychosocial support group (OR 7.4 CI 3.6-15.3 p < 0.001). There were no appropriate guidelines on disclosure and only half of health providers had training on disclosure of HIV serostatus to children. Conclusion:The overall prevalence of disclosure was low. Psychosocial support groups promoted disclosure.

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supporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Factors affecting disclosure of serostatus to children attending Jinja Hospital Paediatric HIV clinic, Uganda

Namasopo-Oleja¹,

Bagenda²,

Ekirapa-Kiracho³

2015

Afr H. Sci.

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“…Consistent with findings from other studies [9,40], a quarter of the children was informed of their HIV diagnosis by health care providers. The data show an increased involvement of health care providers in disclosing HIV to children than previously reported in South Africa [23,24], and other settings [8,21]. The caregiver's need to be supported in the disclosure discussion by health care providers have been previously reported [12,17,19,21,23].…”

Section: Discussionmentioning

confidence: 62%

“…Nonetheless, these studies were conducted before the roll out of ART to children in South Africa. Although disclosure has become part of the comprehensive care of HIV infected children in South Africa, caregivers and health care providers continue to struggle with disclosure to HIV infected children till later in adolescence [6,8,24,25]. The most common reasons for delaying disclosure include; fear of hurting the child, that the child is too young to understand, fear that the child will not be able to keep the secret and will be socially rejected and discriminated, fear that disclosure will have negative emotional consequences for the children, and because caregivers believed that they did not know how to tell or how to approach the disclosure process [5,12,17,26,27].…”

Section: Introductionmentioning

confidence: 99%

Patterns of HIV Diagnosis Disclosure to Infected Children and Family Members: Data from a Paediatric Antiretroviral Program in South Africa

Madiba¹

2012

WJA

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The study examined the patterns of disclosing the HIV diagnosis to infected children and family members, and determined the demographic characteristics associated with disclosure. Semi structured interviews were conducted with caregivers of HIV infected children aged 4 -17 years receiving antiretroviral treatment (ART). A total of 149 caregivers were recruited from a paediatric HIV clinic of a district hospital in South Africa. Caregivers reported that 59 (39.6%) children were told their HIV diagnosis, and majority 36 (61%) were informed of the diagnosis by people other than their biological mothers. Older child age was a determining factor for HIV disclosure to children, 22 (37.2%) learned of their HIV diagnosis between 11 and 16 years. The mean age of disclosed children was 10.6 years. Caregivers took about 3 years after the initial HIV diagnosis to disclose to children, while 143 (99.3%) caregivers reported that disclosure to family members happened immediately after the child's HIV diagnosis. About 28 (31.5%) non-disclosed caregivers planned to disclose to the child between 12 and 18 years, while 13 (14.6%) were not sure about the ideal age to disclose to the child. The lack of consensus regarding the appropriate age for disclosure and the delayed age for future disclosure, suggest that despite increased access to ART for children, there are still significant barriers to disclosing HIV to infected children in this setting. There is a need for health care providers to support caregivers to disclose shortly after diagnosis especially in view of the older age of diagnosis among children enrolled in ART program in this setting.

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“…With increased access to ART, HIV infected children are surviving to older ages, and disclosure has become an essential part of their comprehensive medical care [3]. However, data from studies conducted in developing countries show that many HIV infected children on ART do not know their HIV diagnosis [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Prevalence And Factors Associated With Disclosure Of HIV Diagnosis To Infected Children Receiving Antiretroviral Treatment In Public Health Care Facilities In Gauteng ,South Africa.

Madiba¹,

Mahloko²,

Mokwena³

2013

JCRHAP

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:HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4-17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child's age older than 10 years (OR =1.63; 95% CI: 1.44-1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47-0.87), and caregiver's age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities.

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Healthcare Providers' Perspectives on Discussing HIV Status with Infected Children

Cited by 73 publications

References 6 publications

Factors affecting disclosure of serostatus to children attending Jinja Hospital Paediatric HIV clinic, Uganda

Factors affecting disclosure of serostatus to children attending Jinja Hospital Paediatric HIV clinic, Uganda

Patterns of HIV Diagnosis Disclosure to Infected Children and Family Members: Data from a Paediatric Antiretroviral Program in South Africa

Prevalence And Factors Associated With Disclosure Of HIV Diagnosis To Infected Children Receiving Antiretroviral Treatment In Public Health Care Facilities In Gauteng ,South Africa.

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