Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Vreeman, Rachel C.; Scanlon, Michael; Marete, Irene; Mwangi, Ann; Inui, Thomas S.; McAteer, Carole I.; Nyandiko, Winstone

doi:10.1080/09540121.2015.1026307

Cited by 46 publications

(73 citation statements)

References 45 publications

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“…The commonest immediate emotional impacts of the disclosure were depression, sadness and shock. This was in keeping with the fears of the caregivers in delaying disclosure [21,22] and findings from other studies [16,23,24]. Namukwaya, et al [25] observed that disclosure of HIV status to children led to them being terrified, worried, confused, and intensely emotional.…”

Section: Fig 2 Major Concerns About Being Hiv-infectedsupporting

confidence: 83%

HIV Disclosure in Children in a Tertiary Hospital in Southern Nigeria–Child’s Perspective

Eneh

Ugwu

Paul

2020

AJMAH

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Background: Disclosure of HIV status to children is essential for disease management. Studies on disclosure in children have largely described it from the health provider's perspective or caregiver's perspective. Caregivers' and children's reports about children's feelings and distress can however differ. Understanding the disclosure process from the perspective of HIV-positive children will therefore better portray the impact it had on them. Aim: The aim of the study was to explore from the child's perspective the process of disclosure, the impact it had on them, how they have coped and suggestions on how they think it could be done better. Methods: A cross-sectional study of HIV-infected children and adolescents aged 8-18 years who are aware of their status attending paediatric HIV clinic at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria from April 2015 to March 2016. Data were collected using an open-ended questionnaire administered by a Paediatric health care provider. Information sought included: Biodata (age, gender), educational levels of the child, family characteristics (primary caregiver, orphan status), age at disclosure, process of disclosure, the impact of the disclosure, how they have coped, what they did not like about the way they were told and suggested better ways of telling the children. Results: Seventy-eight HIV-positive children and adolescents were interviewed. Their ages ranged from 8 -18 yrs with a mean age of 14.74±2.23 years. Forty (51.3%) were males, 50 (64.1%) were Eneh et al.; AJMAH, 18(1): 16-27, 2020; Article no.AJMAH.55078 17 in secondary schools, 43 (55.1%) were orphans and the mode of transmission was vertical in 70 (89.7%). In majority 33 (42.3%), the biologic mother was the primary caregiver. Majority of the children 34 (43.6%) had their status disclosed to them between 13 and 14 years. The mother alone did the disclosure in 30 (38.5%). Thirty-six (46.2%) were already aware of their status before disclosure. Disclosure was a one-off event without discussions in 48 (61.5%). The commonest immediate reactions was depression 48 (61.5%). The majority 48(61.5%) became more prayerful as a coping strategy. All 78 (100%) agreed that disclosure has positively impacted on their taking their ARV drugs and clinic attendance. Concerning suggestions from the children, 36 (46.2%) said the most appropriate age for disclosure should be 12-13 years, 54 (69.2%) suggest that both parents should do the disclosure while 60 (76.9%) said that the children should be told how they got infected. Their major concern was having to take drugs for life 60 (76.9%). Conclusion: Disclosure process is suboptimal. Understanding the disclosure process from the perspective of HIV-infected children, therefore, is critical to developing interventions to improve disclosure. Most of the parent's fears of negative impact of status disclosure may be exaggerated. There is need for health care providers to develop a plan with the caregivers of HIV-infected children on the optimal disclo...

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Section: Fig 2 Major Concerns About Being Hiv-infectedsupporting

confidence: 83%

HIV Disclosure in Children in a Tertiary Hospital in Southern Nigeria–Child’s Perspective

Eneh

Ugwu

Paul

2020

AJMAH

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“…In addition, external events, such as enrollment in school (25, 33) or admission to the hospital (35, 36, 40), were cited as motivating disclosure.…”

Section: Discussionmentioning

confidence: 99%

“…At least one study, interviewing children, reported that disclosure was not associated with more negative psychological outcomes (40). Knowing one’s HIV status does appear to be associated with stable or improved child well-being (18, 48) and disease management (11–13).…”

Section: Discussionmentioning

confidence: 99%

Why Tell Children: A Synthesis of the Global Literature on Reasons for Disclosing or Not Disclosing an HIV Diagnosis to Children 12 and under

Krauss

Letteney

Okoro

2016

Front. Public Health

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While the psychological and health benefits of knowing one’s HIV diagnosis have been documented for adults and adolescents, practice is still in development for younger children. Moderating conditions for whether or not to tell a child he/she has HIV vary by region and local context. They include accessibility of treatment, consideration of HIV as a stigmatizing condition, prevalence of HIV, and an accompanying presumption that any illness is HIV-related, parent or caregiver concerns about child reactions, child’s worsening health, assumptions about childhood and child readiness to know a diagnosis, and lack of policies such as those that would prevent bullying of affected children in schools. In this systematic review of the global literature, we summarize the reasons caregivers give for telling or not telling children 12 and under their HIV diagnosis. We also include articles in which children reflect on their desires for being told. While a broad number of reasons are given for telling a child – e.g., to aid in prevention, adaptation to illness (e.g., primarily to promote treatment adherence), understanding social reactions, and maintaining the child–adult relationship – a narrower range of reasons, often related to immediate child or caregiver well-being or discomfort, are given for not telling. Recommendations are made to improve the context for disclosure by providing supports before, during, and after disclosure and to advance the research agenda by broadening samples and refining approaches.

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“…The retained variables were again assessed for internal consistency using Cronbach's Alpha to ascertain that the internal consistency for each domain improved. Furthermore, the retained variables in each domain were summed up and scaled so as to derive a score ranging from 0 to100 using the following formula [32].…”

Section: Data Collection and Analysismentioning

confidence: 99%

Evaluation of Health Surveillance System Attributes: The Case of Neglected Tropical Diseases in Kenya

Ng'etich

Voyi

Mutero

2020

Preprint

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Background: Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) relies on strengthened health systems. Efficient health information systems provide an impetus to achieving the sustainable development goal aimed at ending PC-NTD epidemics. However, there is limited assessment of surveillance system functions linked to PC-NTDs that is hinged on optimum performance of surveillance system attributes. The study aimed to evaluate surveillance system attributes based on healthcare workers’ perceptions in relation to PC-NTDs endemic in Kenya. Methods: A cross-sectional health facility survey was used to purposively sample respondents involved in surveillance activities. Consenting respondents completed a self-administered questionnaire that assessed their perceptions towards surveillance system attributes on a five-point likert scale. Frequency distribution for each point in the likert scale was analysed to determine health worker’s overall perception. Data was analysed using descriptive statistics and estimated median values with corresponding interquartile ranges used to summarise reporting rates. Factor analysis identified variables measuring specific latent attributes. Pearson’s chi-square and Fisher’s exact tests examined associations between categorical variables. Thematic analysis was performed for the questionnaire open-ended responses.Results: Most (88%) respondents worked in public facilities with 71% in second-tier facilities. Regarding PC-NTDs, 55% of respondents perceived the surveillance system to be simple, 50% to be acceptable, 41% to be stable, 41% to be flexible, 51% to be useful and 25% to providing quality data. Facility locality, facility type, respondents’ education level and years of work experience were associated with perceived opinion on acceptability (p = 0.046; p = 0.049; p = 0.032 and p = 0.032) and stability (p = 0.030; p = 0.022; p = 0.015 and p =0.024) respectively. Median monthly reporting timeliness and completeness rates for facilities were 75 (58.3, 83.3) and 83.3 (58.3, 100) respectively. Higher-level facilities met reporting timeliness (p <0.001) and completeness (p <0.001) thresholds compared to lower-level facilities.Conclusion: Health personnel had lower perceptions on the stability, flexibility and data quality of the surveillance system. Reporting timeliness and completeness rates decreased in 2017 compared to previous surveillance periods. Strengthening all surveillance functions would influence health workers’ perceptions and improve surveillance system overall performance regarding PC-NTDs.

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Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Cited by 46 publications

References 45 publications

HIV Disclosure in Children in a Tertiary Hospital in Southern Nigeria–Child’s Perspective

HIV Disclosure in Children in a Tertiary Hospital in Southern Nigeria–Child’s Perspective

Why Tell Children: A Synthesis of the Global Literature on Reasons for Disclosing or Not Disclosing an HIV Diagnosis to Children 12 and under

Evaluation of Health Surveillance System Attributes: The Case of Neglected Tropical Diseases in Kenya

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