Abstract
Background: Human Immunodeficiency Virus (HIV) disclosure to infected children and adolescents is very essential for maintaining personal health and for prevention of HIV within the larger population. HIV non-disclosure has been identified as one of the potential barriers to optimum adherence especially in children and adolescents[1].There has been a significant increase in the survival of HIV infected children with the advent of antiretroviral therapy (ART). But, HIV status disclosure to children remains a complex and a critical clinical issue in the care of HIV-infected children[2].
Methodology: A hospital-based cross-sectional study was conducted at the ART centre of tertiary care hospital in central India from June 2017 to May 2018. Caregivers of HIV positive children ≤15 years of age and on antiretroviral therapy were interviewed and data regarding asocio-demographic variables and pattern of disclosure of HIV status was obtained using a pre tested, structured questionnaire.
Result: We found that maximum caregivers were parents and HIV status ware informed by 105(44.70%) caregivers only. 131(55.70%) of caregivers were not sure about the appropriate age for HIV status disclosure. The main reason for not disclosing HIV status to children was that the child was too young to disclose. Statistically significant association present between socioeconomic status and by caregivers and also between education of caregivers and pattern of disclosure.
Conclusion: More than 50% of children were not informed about their HIV status by caregivers. The main reason for not disclosing HIV status to children was that ‘the child was too young to disclose followed by ‘due to feelings of guilt’.
Keywords: HIV, disclosure, caregivers.
References
- Hayfron-Benjamin A, Obiri-Yeboah D, Ayisi-Addo S, Siakwa PM, Mupepi S. HIV diagnosis disclosure to infected children and adolescents; Challenges of family caregivers in the Central Region of Ghana. BMC Pediatr. 2018;18[1]:1–11.
- Kallem S, Renner L, Ghebremichael M, Paintsil E. Prevalence and pattern of disclosure of HIV status in HIV-infected children in Ghana. AIDS Behav [Internet]. 2011 Aug [cited 2020 Dec 23];15[6]:1121–7. Available from: /pmc/articles/PMC2989337/?report=abstract
- Poudel P, Pokharel R, Chitlangia M, Chaudhary S. Profile of HIV infected children: A hospital based study at Eastern Nepal. Asian Pacific J Trop Dis. 2014;4[3]:169–75.
- HIV Statistics - Global and Regional Trends - UNICEF DATA [Internet]. [cited 2020 Dec 23]. Available from: https://data.unicef.org/topic/hivaids/global-regional-trends/
- Guideline on {HIV} {Disclosure} {Counselling} for {Children} {Up} to 12 {Years} of {Age}. Guideline [Internet]. 2011;46. Available from: http://www.ncbi.nlm.nih.gov/books/NBK304307/
- Kallem S, Renner L, Ghebremichael M, Paintsil E. Prevalence and pattern of disclosure of HIV status in HIV-infected children in Ghana. AIDS Behav. 2011;15[6]:1121–7.
- Wiener L, Mellins CA, Marhefka S, Battles HB. Disclosure of an HIV diagnosis to children: History, current research, and future directions. J Dev Behav Pediatr. 2007;28[2]:155–66.
- Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2008;20[10]:1266–75.
- Bhattacharya M, Dubey AP, Sharma M. Patterns of diagnosis disclosure and its correlates in HIV-infected north Indian children. J Trop Pediatr. 2011;57[6]:405–11.
- Mumburi LP, Hamel BC, Philemon RN, Kapanda GN, Msuya LJ. Factors associated with HIV-status disclosure to HIV-infected children receiving care at Kilimanjaro Christian Medical Centre in Moshi, Tanzania. Pan Afr Med J. 2014;18:1–8.
- Verma D, Acharya AS, Bachani D, Seth A. Clinico-Social and Immunological Profile of Antiretroviral Naïve Children Living With HIV In Tertiary Care Hospital, Delhi. SAARC J Tuberc Lung Dis HIV/AIDS [Internet]. 2017;13[1]:32. Available from: http://www.nepjol.info/index.php/SAARCTB/article/view/16926
- Madiba S, Mokgatle M. Fear of stigma , beliefs , and knowledge about HIV are barriers to early access to HIV testing and disclosure for perinatally infected children and adolescents in rural communities in South Africa Fear of stigma , beliefs , and knowledge about HIV are bar. South African Fam Pract [Internet]. 2017;6190(May):1–7. Available from: http://doi.org/10.1080/20786190.2017.1329489
- Gyamfi E, Okyere P, Enoch A, Appiah-brempong E. Prevalence of , and barriers to the disclosure of HIV status to infected children and adolescents in a district of Ghana. 2017;1–8.
- Oberdorfer P, Puthanakit T, Louthrenoo O, Charnsil C, Sirisanthana V, Sirisanthana T. Disclosure of HIV/AIDS diagnosis to HIV-infected children in Thailand. J Paediatr Child Health. 2006;42[5]:283–8.
- Vaz LME, Maman S, Eng E, Barbarin OA, Tshikandu T, Behets F. Patterns of disclosure of HIV status to infected children in a Sub-Saharan African setting. J Dev Behav Pediatr. 2011;32[4]:307–15.
- Nilesh T, Gadhavi RN, Pradip D, Ushma B, Samir B, Nisarg P. Sociodemographic profile and health status of children living with HIV-AIDS attached to an NGO (ADHAR) of Ahmedabad city. Int J Med Sci Public Heal. 2015;4[6]:773–6.
- Anyabolu HC, Adejuyigbe EA, Adeodu OO, Access O, Anyabolu HC, Adejuyigbe EA, et al. Undernutrition and anaemia among HAART-naïve HIV infected children in Ile-Ife, Nigeria: A case-controlled, hospital based study. Pan Afr Med J. 2014;18:1–8.
- Lorenz R, Grant E, Muyindike W, Maling S, Card C, Henry C, et al. Caregivers’ attitudes towards HIV testing and disclosure of HIV status to at-risk children in rural Uganda. PLoS One. 2016;11[2]:1–22.
- Binagwaho, I. Murekatete, A. Rukundo, P. Mugwaneza, R. Hinda, A. Lyambabaje, J.D. Bizimana, C.M. Wagner, G. Muriisa, J. Muita, V. Mutabazi, J.P. Nyemazi, S. Nsanzimana CK. Original Article FACTORS ASSOCIATED WITH DISCLOSURE OF HIV STATUS AMONG HIV-. Rwanda Med J. 2012;69(September):9–15.
Corresponding Author
Dr Kanchan D. Ingle
Assistant Professor, Department of Community Medicine, GMC Nagpur, Maharashtra, India