Disclosure of HIV/AIDS status to infected children in Ghana – A north-south comparison of barriers and enablers

Appiah, Seth Christopher Yaw; Ivanova, Olena; Höelscher, Michael; Kroidl, Inge; Dapaah, Jonathan Mensah

doi:10.1016/j.childyouth.2020.105753

Cited by 5 publications

(9 citation statements)

References 40 publications

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“…Age was only signi cant in two of our models. Teenage mothers (15)(16)(17)(18)(19) were more likely to be physically abused (AOR= 2.460; CI: 1.451-4.170), while women between in the age group 20-29 had a lower risk of being neglected after birth (AOR=0.80; CI: 0.657-0.982) compared to mothers who were older than 30 years. Education was only statistically signi cant in the non-consented care category and the discriminated care category, while women with no formal education are more likely to experience these forms of violence (non-consented care: AOR=1.725; CI: 1.020-2.916; discriminated care: AOR=1.562; CI: 1.007-2.423) compared to women with at least some education.…”

Section: Resultsmentioning

confidence: 99%

Obstetric violence among HIV positive and negative women in Ghana: A cross sectional study in two regions

Appiah

Yalley

Ahlin

et al. 2023

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Background: Although the problem of obstetric violence (OV) is receiving increasing attention among academics and policy makers, the prevalence and associated factors of OV are still poorly understood. The fear of OV prevents women from giving birth in health facilities, which is crucial for the effectiveness of HIV prevention programs, such as the Prevention of Mother to Child Transmission (PMTCT) program. Objective: The aim of this paper is to determine the prevalence of OV, the comparative burden and associated predictors between HIV positive and negative women in Ghana. Methods: The present study is a facility-based cross-sectional study enrolling 2,142 women, of which 310 were HIV positive and 1,832 HIV negative with a birth history of 0-24 months. The women were enrolled consecutively using a two stage sampling technique from eight hospitals with antiretroviral clinics across two regions in Ghana. The primary outcome variable was the experience of OV and its various forms. Descriptive data is presented in tables and reported in frequencies. The inferential analysis has been performed by estimating the Adjusted Odds Ratios (AOR) using multivariate logistic regression. Results: Prevalence of OV was slightly lower among HIV positive women (61.0%) compared to HIV negative women (65.1%), though this was not statistically significant (χ2=1.99; p=0.158). The most common sub-category of OV experienced by all women was non-confidential care (35.2%). HIV positive women experienced more abandoned care (32.6%) with non-consented care being the least prevalent form of OV. Experience of discrimination was higher among HIV positive women (13.5%) than HIV negative women (10.8%). The multivariate regression analysis of the predictors of OV suggests that HIV positive women are not more likely to experience OV. Instead, we find evidence that HIV positive women are less likely to be subjected to physical violence (AOR=0.512; CI: 0.369-0.710), non-consented care (AOR=0.457; CI: 0.244-0.859) and non-dignified care (AOR= 0.688; CI: 0.513-0.923). Conclusions: The study shows high rates of OV among all women. However, we found no evidence that HIV positive women were at higher risk to experience OV than HIV negative women. Evidence based interventions are required to address OV due to its threat to facility-based childbirth and the PMTCT cascade of care.

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Section: Resultsmentioning

confidence: 99%

Obstetric violence among HIV positive and negative women in Ghana: A cross sectional study in two regions

Appiah

Yalley

Ahlin

et al. 2023

Preprint

Self Cite

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“…There were 11,261 published papers found in the four databases searched and including the references from the papers reviewed. After article duplicates were excluded, assessments of abstracts completed, and full-text papers evaluated, 37 studies were retained for inclusion in this meta-analysis [ 5 , 9 , 31 – 65 ]. Of the 37 studies, 34 were based on data collected from the African Region ( n = 22,351 participants) and three from the South-East Asian Region ( n = 549 participants).…”

Section: Resultsmentioning

confidence: 99%

“… 405 2013 2017 Cross-section Good * Danjuma et al [ 27 ] 160 2021 2017 Cross-section Satisfactory * John-Stewart et al [ 28 ] 271 2013 2006–2007 Cross-section Good Murnane et al [ 29 ] 553 2017 2013–2014 Cross-section Good Odiachi and Abegunde [ 30 ]. 110 2015 2015 Cross-section Good * Beima-Sofie et al [ 31 ] 314 2017 2013 Cross-section Very Good Tucho et al [ 32 ] 327 2021 2020 Cross-section Good * * * Biadgilign et al [ 33 ] 390 2008 2011 Cross-section Very Good * * …”

Section: Resultsmentioning

confidence: 99%

“…Thirty-four studies [ 5 , 9 , 31 – 41 , 43 , 44 , 46 – 59 , 61 – 64 ] reported the prevalence rate of disclosure of HIV/AIDS status to infected children. Thirteen studies were from a low income country setting [ 5 , 32 – 34 , 38 – 40 , 46 , 49 , 51 , 59 , 62 , 63 ], fourteen studies were in a lower middle income country setting [ 31 , 35 – 37 , 41 , 44 , 47 , 48 , 52 , 53 , 55 , 56 , 58 , 61 ] and eight were from a upper-middle-income country [ 9 , 43 , 50 , 54 , 57 , 64 , 65 ]. The studies were published between 2008 and 2021, and the sample sizes ranged from 39 to 10,673.…”

Section: Resultsmentioning

confidence: 99%

“…Seven cross-sectional studies [ 31 , 37 , 38 , 46 , 47 , 61 , 62 ] examined the relationship between ART adherence and disclosure of HIV/AIDS status to infected children. Four studies were conducted in a lower-middle-income country setting [ 31 , 37 , 47 , 61 ], and three studies were conducted in a low-income country setting [ 38 , 46 , 62 ]. Studies were published between 2011 and 2021, with sample sizes ranging from 39 to 792.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence, socio-demographics and service use determinants associated with disclosure of HIV/AIDS status to infected children: a systematic review and meta-analysis by 1985–2021

et al. 2022

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Background Human immunodeficiency virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) is a public health issue of global importance. To our knowledge, no previous meta-analysis documenting the prevalence, socio-demographic, and service use determinants associated with HIV/AIDS disclosure to infected children has been conducted. The present study aimed to determine the prevalence, socio-demographics and service use determinants associated with the disclosure of HIV/AIDS status to infected children. Methods Studies in English published between 01 January 1985 and 01 November 2021, and available on PubMed, Scopus, Web of Science, and Cochrane electronic databases were searched. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR), and 95% confidence intervals. Results After article duplicates were excluded, assessments of abstracts were completed, and full-text papers evaluated, 37 studies were included in this meta-analysis. The prevalence of the disclosure of HIV status to children was measured to be 41% in this research. The odds that a child of 10 years and older is informed that they are HIV-positive is 3.01 time the odds that younger children are informed. Those children who had primary or lower schooling level were 2.41 times more likely to be informed of their HIV-positive status than children with higher levels of schooling. Children who had a non-biological parents were 3.17 times more likely to have been disclose being HIV-positive; social support (OR = 8.29, 95%CI = 2.34, 29.42), children who had higher levels of social supports were 8.29 times more likely to disclose HIV-positive; the primary educational level of caregivers (OR = 2.03, 95%CI = 1.43, 2.89), respondents who had caregivers with primary education level were 2.03 times more likely to disclose HIV-positive; antiretroviral treatment (ART) adherence (OR = 2.59, 95%CI = 1.96, 3.42), participants who adhered to ART were 2.59 times more likely to disclose HIV-positive and hospital follow-up (OR = 2.82, 95%CI = 1.85, 4.29), those who had hospital follow-up were 2.82 times more likely to disclose HIV-positive; were all significantly associated with the disclosure of HIV/AIDS status to infected children. Conclusion Such data are of importance for healthcare pediatrics HIV care professionals. Facilitating HIV diagnosis and disclosure to the infected children and ensuring access to HIV treatment will likely prevent secondary HIV transmission. Healthcare professionals are expected to provide age-appropriate counseling services to this population.

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‘Mummy told me that I have HIV, that is the only thing she told me’: Experiences of HIV status disclosure to children in Masaka Region, Uganda

et al. 2023

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Background In sub-Saharan Africa (SSA), disclosure of HIV status to children remains low. Few studies have examined how children navigate and come to terms with their HIV status. The aim of this study was to explore experiences of children about disclosure of their HIV status. Methods Between October 2020 and July 2021, 18 purposively selected children aged between 12–17 whose HIV status had been disclosed to them by their caregivers or healthcare providers (HCPs) were recruited for this study. We conducted 18 in-depth interviews (IDIs) to collect data for this study. Data were analyzed using the semantic thematic analysis approach. Results Primary data obtained through IDIs revealed that disclosure of HIV status to children occurred as a one-time event without pre—disclosure preparatory planning or focused post disclosure follow-up counseling irrespective of the discloser. Post disclosure psycho-social experiences elicited mixed responses. Some children experienced insults and belittlement and stigma and discrimination in the family and community for out-of-school children and at school for school-going children. Positive disclosure experiences involved receiving support to improve ART adherence through constantly being reminded to take their medications timely at the workplace, by supervisors, for working children and by teachers, at school for school-going children. Conclusions This research contributes to knowledge about children’ s experiences of being HIV infected and can specifically be used to improve disclosure strategies.

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Disclosure of HIV/AIDS status to infected children in Ghana – A north-south comparison of barriers and enablers

Cited by 5 publications

References 40 publications

Obstetric violence among HIV positive and negative women in Ghana: A cross sectional study in two regions

Obstetric violence among HIV positive and negative women in Ghana: A cross sectional study in two regions

Prevalence, socio-demographics and service use determinants associated with disclosure of HIV/AIDS status to infected children: a systematic review and meta-analysis by 1985–2021

‘Mummy told me that I have HIV, that is the only thing she told me’: Experiences of HIV status disclosure to children in Masaka Region, Uganda

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