Disclosure of HIV Status to Children in Sub-Saharan Africa: A Systematic Review

Doat, Abdul Razak; Negarandeh, Reza; Hasanpour, Marzieh

doi:10.3390/medicina55080433

Cited by 50 publications

(69 citation statements)

References 30 publications

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“…In a review of articles from Sub-Saharan Africa the prevalence of HIV disclosure ranged from as low as 9% to 72% [16]. The rate of disclosure of HIV status to infected children and adolescents remains generally low in developing countries probably because of cultural norms that children are not permitted to ask many questions.…”

Section: Discussionmentioning

confidence: 99%

HIV Disclosure in Children in This Millenium – Should It still be an Issue?

Eneh

Ugwu

Paul

2020

AIR

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Background: As more children with HIV survive into adolescence and adulthood, one of the most difficult issues that families with HIV-infected children face is disclosure of their children’s status to them. Objective: To explore factors associated with disclosure or none disclosure and whether disclosure is beneficial or not. Methods: The mothers of HIV positive children who brought their children aged 5-18 years to the Paediatric Infectious Disease Clinic of the University of Port Harcourt Teaching Hospital from January to December 2015 were interviewed using a structured investigator administered questionnaire. Results: Of the 100 caregivers interviewed, 26.0% have disclosed the HIV status to the children. The mean age at disclosure was 14.42 ± 2.45 years. Care givers that have disclosed were significantly older (45.58±8.32 years vs 38.18±9.2 years; p = .0002). The mean age of children whose status have been disclosed was significantly higher than those who were yet to be aware of their status (14.42±2.45years vs 10.97±3.11 years; p = 0.00001). There was no significant difference in the mode of transmission and orphan status between the two groups. Disclosure was significantly more among children who were diagnosed between 5-10 years of age (14; 53.8%) (p=0.013), have taken antiretroviral drugs for over 24 months (22; 84.6%) (p= 0.003) and had at least one HIV-infected sibling (21; 80.8%) (p=0.00001). Among 13 (50.0%) whose status have been disclosed and 59 (79.7%) whose status had not been disclosed, the caregiver had disclosed the child’s status to others (p= 0.004). The major reason for disclosing was because the child was either asking questions on why he/she is taking drugs or he/she is refusing to take drugs (15; 57.7%) respectively. Only 6 (23.1%) caregivers disclosed because they felt the child has a right to know. Most difficult question asked by the children during disclosure was how they got the HIV (22; 84.6%). Reasons given for non-disclosure included fear of disclosure to others (74; 100%), child too young to understand (70; 94.5%) and fear of impact on child’s emotional health (42; 56.7%). Majority 20 (76.9%) of the care givers felt relieved after disclosure. Twenty-four (92.3%) caregivers felt disclosure had improved child’s adherence to antiretroviral therapy and determination to survive (22; 84.6%). Conclusion: Disclosure is beneficial to both the child and caregiver. Healthcare providers should encourage caregivers to disclose HIV status to their children as soon as possible.

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Section: Discussionmentioning

confidence: 99%

HIV Disclosure in Children in This Millenium – Should It still be an Issue?

Eneh

Ugwu

Paul

2020

AIR

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“…Disclosure process should span through understanding the disease, its progress, its origins, its name, its consequences, and its management. Optimal disclosure is disclosure that is prepared, accidental, health-promoting with the child/adolescent made fully aware of own illness and its consequences, age appropriate, timely, starting as early as possible, family centered, takes place within a supportive and enabling environment and is l appropriate support [4,14]. A child is never "not ready" for some level of disclosure even if it means just starting with learning something 22…”

Section: Discussionmentioning

confidence: 99%

“…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 [1][2][3] or caregivers perspective [4,5], but not much study has been done to characterize the actual impact of disclosure on the children as reported by the children themselves. For these children, learning about their HIV diagnosis is necessary to building trusting family relationships and an important step towards long-term disease management and transition from paediatric/ adolescent care into adult care settings.…”

Section: Introductionmentioning

confidence: 99%

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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“…Even though there is literature about the perpetration of IPV in Sub-Saharan Africa and Ghana (Addo-Lartey et al, 2019;Adomako & Darkwa Baffour, 2019;Amegbor, Yankey, Rosenberg, & Sabel, 2020;Apatinga & Tenkorang, 2020;Baffoe-Whyte & Sossou, 2019;Cofie, 2018;Dako-Gyeke et al, 2019;Dery, 2019;Dickson et al, 2020;Doat, Negarandeh, & Hasanpour, 2019;Issahaku, 2015;Owusu-Addo et al, 2018;E. Y. Tenkorang, 2019), no single study has been done with the factors that led to male partners' perpetration of violence against their female HIV positive partners.…”

Section: The Theoretical Basis Of Intimate Partner Violence Perpetrationmentioning

confidence: 99%

Forms of and Factors Associated With Perpetration of Intimate Partner Violence by Men on Their Female Partners Following HIV Status Disclosure in the Ashanti Region of Ghana: A Qualitative Study

Apiribu¹,

Ncama²,

Duma³

2020

GJHS

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Background: Men’s experiences of perpetration of intimate partner violence against their female heterosexual partners following disclosure of their HIV positive status is a global health problem. The forms of IPV and factors associated with IPV following the disclosure are under-researched. In this article, we aim to explore and describe the forms of and factors associated with men’s experiences of perpetration of IPV against their female partners following the disclosure of seropositive HIV status. Methods: An exploratory qualitative research design using an interpretive phenomenological analysis method was employed for the data collection from participants (men) who perpetrated violence against their HIV positive women. The study setting was done in two HIV clinics in two Hospitals. The study population consisted of all men whose intimate partners had been diagnosed HIV positive and made known to their partners and are seeking healthcare at the two HIV clinics. Purposive sampling technique was employed to recruit participants for the study. An interpretive phenomenological approach was employed for the collection and analysis from eighteen men whose partners had recently disclosed their seropositive HIV status. An interview guide was the tool employed for the data collection. Data collection and analysis were undertaken concurrently. Results: Most of the participants identified and described the forms of and factors associated with IPV influencing them to perpetrate IPV. Five themes and sub-themes emerged and these include; emotional factors, spousal related factors, Social related factors, Sex-related factors and some forms of IPV which were identified by participants. Each of these themes has subthemes. Conclusion: Men use different forms of IPV violence in abusing women who disclosure their HIV seropositive status. Several factors as identified in this study accounts for this partner violence. Forms and factors associated with intimate partner violence should be used as a guide in formulating policies and developing a guide that can be utilised in the early detection of IPV in this category of women.

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Disclosure of HIV Status to Children in Sub-Saharan Africa: A Systematic Review

Cited by 50 publications

References 30 publications

HIV Disclosure in Children in This Millenium – Should It still be an Issue?

HIV Disclosure in Children in This Millenium – Should It still be an Issue?

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

Forms of and Factors Associated With Perpetration of Intimate Partner Violence by Men on Their Female Partners Following HIV Status Disclosure in the Ashanti Region of Ghana: A Qualitative Study

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