Mental Health and Disclosure of HIV Status in Zambian Adolescents With HIV Infection

Menon, J. Anitha; Glazebrook, Cris; Campain, Nicholas; Ngoma, Mary Shilalukey

doi:10.1097/qai.0b013e3181565df0

Cited by 147 publications

(178 citation statements)

References 31 publications

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“…31 Being on ART and duration on ART was significantly associated with disclosure. It is similar to a study by Menon et al, 32 in Zambia who reported that children on antiretroviral therapy were most likely disclosed to. However the findings in this study are different from what was reported in Thailand where being on ART and duration on ART were not significantly associated with disclosure.…”

supporting

confidence: 78%

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: 78%

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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“…34,37 In this study's setting, providers were concerned with finding the best way to disclose to children, and were therefore not intervening with what they saw as the ''natural'' disclosure process currently taking place until more information was made available. It is likely that for this reason, as well as the comparatively short period of time since ART was made available in this setting, the prevalence of disclosure among infected youth is lower than what has been documented in other similar settings, 38,39 The Zimbabwe study looked at adolescents between the ages of 11-15 years only, 39 whereas this study included children ages 5-17 years; age is associated with disclosure studies. 18 Data from the quantitative component of this study, presented in a separate article, note that caregivers want to be involved in the decisions and the processes revolving around disclosure, but that they also want support from health care providers.…”

Section: Discussionmentioning

confidence: 90%

Telling Children They Have HIV: Lessons Learned from Findings of a Qualitative Study in Sub-Saharan Africa

Vaz

Eng

Maman

et al. 2010

AIDS Patient Care and STDs

171

257

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HIV-infected children in developing countries are living longer lives as they gain access to antiretroviral treatment programs. As they grow older, their parents=guardians are faced with the difficult decision of if, when, and how to inform their child of his=her HIV status. Both negative and positive social, psychological, and behavioral impacts of disclosure to children have been reported, including improved adherence to medication regimens. Understanding the disclosure process from the perspective of HIV positive children, therefore, is critical to developing these interventions. Through children's experiences we can learn about what works well, what needs to be strengthened, and what is missing in current disclosure practices. We conducted in-depth interviews with eight caregiver-child dyads in Kinshasa, Democratic Republic of the Congo. The children were in a comprehensive HIV pediatric care and treatment program and had already been told their HIV diagnosis. For the analysis we placed particular emphasis on children's reports of communication with their caregivers and health care providers about their illness. Patterns emerged of limited communication between children and their caregivers as well as their providers, before, during, and after disclosure. From the perspective of children in this study, disclosure was largely a discrete event rather than a process. Sociocultural contexts surrounding HIV=AIDS, as well as health status, variations in parent-child communication and the relationships between health providers and children under their care, should inform psychosocial interventions delivered alongside treatment programs.

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“…Given that no previous psychometric evaluation of the SDQ has taken place in South Africa, the current study therefore aimed to: (i) examine the means, standard deviation, distribution and internal consistency of the SDQ-S in a representative sample of adolescent boys and girls; (ii) compare gender differences in the above psychometric properties; (iii) determine the proportion of boys and girls who scored in the 'normal', 'borderline' and 'abnormal range' of SDQ-S subscales based on UK norms, and, if required, to generate South African cut-off scores; (iv) compare mean SDQ-S scores of the South African sample to previously reported normative data for SDQ-S scores in UK, Australian and Chinese samples; and (v) determine whether the South African SDQ-S data would fit the five-factor structure of the original UK SDQ-S. We hypothesised that significant differences on the basis of gender will exist in SDQ-S scores as found in previous studies (Becker et al 2015;Kremer et al 2015), hypothesised that South African cut-off scores may be required, as reported in other studies from LMICs (Kashala et al 2005;Menon et al 2007;Bakare et al 2010;Cortina et al 2013), and that there would be only partial support for the five-factor structure, as reported elsewhere (Rønning et al 2004;Richter et al 2011;Stevanovic et al 2014). We did not hypothesise any specific patterns of similarities or differences between the South African, UK, Australian and Chinese data, but were keen to explore the crosscountry potential of the instrument.…”

Section: Introductionmentioning

confidence: 98%

Measuring adolescent mental health around the globe: psychometric properties of the self-report Strengths and Difficulties Questionnaire in South Africa, and comparison with UK, Australian and Chinese data

Vries

Davids

Mathews

et al. 2017

Epidemiol Psychiatr Sci

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Aims. This study evaluated the psychometric properties of the Strengths and Difficulties Questionnaire Self-Report (SDQ-S) in South African adolescents, and compared findings with data from the UK, Australia and China.Methods. A sample of 3451 South African adolescents in grade 8, the first year of secondary school (M age = 13.7 years), completed the SDQ-S in Afrikaans, English or isiXhosa. Means, group differences and internal consistency were analysed using SPSS V22, and confirmatory factor analyses were conducted using MPlus V7.Results. In the South African sample, significant gender differences were found for four of the five sub-scale means and for total difficulties, but gender differences of alpha scores were negligible. The internal consistency for the total difficulties, prosocial behaviour and emotional symptoms sub-scales were fair. UK cut-off values for caseness (set to identify the top 10% of scores in a UK sample) led to a higher proportion of South African adolescents classified in the 'abnormal' range on emotional and peer difficulties and a lower proportion classified in the 'abnormal' range for hyperactivity. South African cut-offs were therefore generated. The cross-country comparison with UK, Australian and Chinese data showed that South African adolescent boys and girls had the highest mean scores on total difficulties as well as on the subscales of emotional symptoms and conduct problems. In contrast, South African boys and girls had the lowest mean scores for hyperactivity/inattention. The UK boys and girls had the highest mean scores for hyperactivity/inattention, while the Australian sample had the highest scores for prosocial behaviours. The Chinese boys had the highest peer problem mean scores and Chinese boys and girls had the lowest means on prosocial behaviours. Confirmatory factor analyses showed significant item loadings with loadings higher than 0.40 for the emotional and prosocial behaviour sub-scales on the five-factor model, but not for all relevant items on the other three domains.Conclusions. Findings support the potential usefulness of the SDQ-S in a South African setting, but suggest that the SDQ-S should not be used with UK cut-off values, and indicate the need for further validation and standardisation work in South African adolescents. We recommend that in-country cut-offs for 'caseness' should be used for clinical purposes in South Africa, that cross-country comparisons should be made with caution, and that further examination of naturalistic clusters and factors of the SDQ should be performed in culturally and contextually diverse settings.

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Mental Health and Disclosure of HIV Status in Zambian Adolescents With HIV Infection

Abstract: High rates of emotional and peer problems were found in this sample but disclosure of HIV status did not have a negative effect on mental health. Interventions to promote disclosure could facilitate access to emotional and peer support.

Cited by 147 publications

References 31 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

Telling Children They Have HIV: Lessons Learned from Findings of a Qualitative Study in Sub-Saharan Africa

Measuring adolescent mental health around the globe: psychometric properties of the self-report Strengths and Difficulties Questionnaire in South Africa, and comparison with UK, Australian and Chinese data

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