PREVALENCE OF DISCLOSURE OF HIV POSITIVE STATUS AND ITS PREDICTORS AMONG CHILDREN AND ADOLESCENTS WITH HIV INFECTION ATTENDING THE PAEDIATRIC INFECTIOUS DISEASE CLINIC AT TIKUR ANBESSA SPECIALIZED TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA

Abstract

Background: With the advent of antiretroviral therapy(ART), there has been a significant reduction in morbidity and mortality of HIV-infected children and many of the children are surviving through childhood and into adolescence. Despite emerging evidence of the benefits of disclosure, when and how to disclose the diagnosis of HIV to children remains a clinical dilemma.

Objective: We investigated the prevalence and factors associated with disclosure of HIV positive status to children and effects of disclosure among children with HIV infection.

Methods: A cross-sectional study was conducted among 233 HIV positive children aged 6-18 years from May- July 2013. Data on Socio-demography, disclosure status, age at disclosure and caregivers profile were collected by direct interviewing of caregivers and children. Medical diagnosis, WHO clinical staging, treatment compliance and CD4+ count was obtained from medical records directly. Data was analysed using SPSS version 17.0 software. Descriptive statistics such as frequency, mean, median, standard deviation and range were used to summarize the results. Significance tests and odds ratio were calculated using logistic regression models to examine the predictors and effects of HIV disclosure.

Results: The prevalence of disclosure was 32%. Almost all caregivers agreed that HIV positive status should be disclosed to the children in the future. More than half (52.3%) preferred disclosure to be done by health-care providers only. Age of child >10 years at disclosure, the level of education of the child, longer duration on HIV medication were significantly associated with disclosure. (P≤0.05). Fewer admission rate and administration of own medication among the disclosed group was identified as significant positive effect of disclosure

Conclusion: Prevalence of disclosure is very low accounting only in one third of children on follow clinic and among them only one third of the disclosure was initiated by health workers. Caregivers from non-disclosed groups prefer the disclosure to be by health professional only. It is recommended to address the barrier of disclosure in the perspective of health workers and a longitudinal study to be conducted to see the health impact of disclosure.