Factors associated with HIV/AIDS diagnostic disclosure to HIV infected children receiving HAART: A multi-center study in Addis Ababa, Ethiopia

Department of Epidemiology and Biostatistics, College of Public Health and Medical Science, Jimma University, Jimma, Ethiopia.
PLoS ONE (Impact Factor: 3.23). 03/2011; 6(3):e17572. DOI: 10.1371/journal.pone.0017572
Source: PubMed


Diagnostic disclosure of HIV/AIDS to a child is becoming an increasingly common issue in clinical practice. Nevertheless, some parents and health care professionals are reluctant to inform children about their HIV infection status. The objective of this study was to identify the proportion of children who have knowledge of their serostatus and factors associated with disclosure in HIV-infected children receiving HAART in Addis Ababa, Ethiopia.
A cross-sectional study was conducted in five hospitals in Addis Ababa from February 18, 2008-April 28, 2008. The study populations were parents/caretakers and children living with HIV/AIDS who were receiving Highly Active Antiretroviral Therapy (HAART) in selected hospitals in Addis Ababa. Univariate and multivariate logistic regression analysis were carried out using SPSS 12.0.1 statistical software.
A total of 390 children/caretaker pairs were included in the study. Two hundred forty three children (62.3%) were between 6-9 years of age. HIV/AIDS status was known by 68 (17.4%) children, 93 (29%) caretakers reported knowing the child's serostatus two years prior to our survey, 180 (46.2%) respondents said that the child should be told about his/her HIV/AIDS status when he/she is older than 14 years of age. Children less than 9 years of age and those living with educated caregivers are less likely to know their results than their counterparts. Children referred from hospital's in-patient ward before attending the HIV clinic and private clinic were more likely to know their results than those from community clinic.
The proportion of disclosure of HIV/AIDS diagnosis to HIV-infected children is low. Strengthening referral linkage and health education tailored to educated caregivers are recommended to increase the rate of disclosure.

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Available from: Sibhatu Biadgilign
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    • "Our data showed that the ability to understand the diagnosis, without worrying about it, and being able to keep it a secret, were important markers of maturity and social competence perceived by most caregivers as indicators of the child's readiness to be involved in discussions about their HIV diagnosis and treatment. This finding is consistent with other studies on disclosure to HIV-infected children in resource-limited settings [9, 13, 18, 55, 56]. Caregivers' concern with children's ability to maintain discretion is indicative of the social stigma still attached to HIV. "
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    • "Our study aims at using ADDS to help caregivers develop the skills needed to be able to disclose to their children. The fear of stigma after disclosure of the HIV status to a child has been the most formidable barrier to disclosure (Bhattacharya et al., 2011;Biadgilign et al., 2011;Kallem et al., 2011;Vreeman et al., 2010). Our cohort of caregivers who have not disclosed the HIV status to their children had higher scores on the HIV Stigma Scale. "
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    • "aregiver as a person who lives with the child , participates in the child ' s daily care and is the most knowledgeable about the child ' s health and adherence ( Bikaako - Kajura et al . , 2006 ; Haberer et al . , 2011 ) , Fetzer et al . ( 2011 ) consider the primary caregiver as the adult who primarily serves to assist the child with taking ART . Biadgilign et al . ( 2011 ) define a primary caregiver as a person who persistently assumes responsibility for the housing , health or safety of the child , administers the child ' s medication daily and brings the child for clinic appointments . This contrasts with a broader description of a primary caregiver as the person the child would turn to if he / she ne"
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