HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria

Abstract

Aims: To determine the rate of HIV status disclosure, caregivers’ reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. Methods: Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. Results: Caregivers of 107 children (age 5–16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. Conclusions: There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

“What will my child think of me if he hears I gave him HIV?”: a sequential, explanatory, mixed-methods approach on the predictors and experience of caregivers on disclosure of HIV status to infected children in Gombe, Northeast Nigeria

“…In contrast to other reports, [20,26] girls were 1.45 times more likely than boys to have been disclosed their HIV positive status. This quantitative finding was corroborated by the qualitative component of our study where caregivers shared their views that female children tend to attain 'maturity' earlier than their male counterparts and would therefore be better equipped to cope with the news, thus, explaining the higher likelihood of disclosure to female children in our study setting.…”

“…For example, most children studied in the earlier report were pre-adolescent (mean age 8.8 ± 2.2 years) compared to our study in which the majority were in early and mid-adolescence (mean age 12.2 ± 3.2 years), making disclosure more likely in our study with corresponding higher prevalence. More recent studies in Nigeria by Ubesie et al, [20] and Odiachi et al [21] reported prevalence of disclosure to HIV positive children of 29.5 and 30.9% respectively; comparable to our findings which suggests an increase prevalence of disclosure to Nigerian children living with HIV within recent time. Although relatively higher than most reports from within Nigeria and the African continent, [5,[22][23][24][25][26][27][28] our disclosure rate are lower compared with findings from the US, Canada and Europe [29][30][31].…”

Status Disclosure in HIV Infected Children in Abakaliki, Ebonyi State, Southeast, Nigeria

“…The mean age of HIV disclosure was found to be 12.48± 2.46 years in index study. This was rather late when compared to nine years reported by Mialky et al 14 but similar to 11.52 ±2.25 years reported by Ubesie et al 17 . Studies show that early disclose of HIV status like most chronic illnesses improves self esteem, reduces the risk to fantasies about illness and improves access to care and support.…”

Factors Associated with HIV Status Disclosure and Its Effect on Treatment Adherence and Quality of Life among Children 6–17 Years on Antiretroviral Therapy in Southern Highlands Zone, Tanzania: Unmatched Case Control Study

“…Similar findings have been reported earlier [ 11 – 14 ]. This could be explained by caregivers' belief that younger children are not mature enough to understand the disease [ 15 , 16 ] and by the age of 10 years and above parents gain the confidence to disclose HIV status. On the other hand, it takes a time for the provider to build strong trust with the guardians and the child and therefore delaying the time for status disclosure.…”