Disclosure of the HIV infection status in children

Arun, S; Singh, Ajay K.; Lodha, Rakesh; Kabra, S. K.

doi:10.1007/s12098-009-0177-z

Cited by 50 publications

(73 citation statements)

References 14 publications

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“…These data lend support to previous studies indicating that caregivers desire to be the primary persons to disclose the HIV diagnosis to their children. Almost half of the caregivers in studies conducted in Congo, India, and Thailand, reported that they would like to be the ones who disclose the HIV diagnosis to their children [17,30,38,39]. Consistent with findings from other studies [9,40], a quarter of the children was informed of their HIV diagnosis by health care providers.…”

Section: Discussionsupporting

confidence: 74%

“…However, there seems to be a lack of consensus and knowledge regarding the appropriate age for disclosure in this study and others [6,17,37,38]. Findings from the current study show that some of the non-disclosed caregivers were not sure about the appropriate time to tell children of their HIV diagnosis.…”

Section: Discussioncontrasting

confidence: 56%

“…Findings from the current study show that some of the non-disclosed caregivers were not sure about the appropriate time to tell children of their HIV diagnosis. Data show that the appropriate age of disclosure from studies conducted in developing and well developed countries vary (range 11 -16 years) [6,17,37,38], but the majority of caregivers in developing countries felt that the child should be told about their HIV diagnosis around 14 years [6,17,38]. The older intended age of disclosure observed in this study and others suggest that despite increased access to ART for children in developing countries, there are still significant barriers to disclosing the HIV diagnosis to children.…”

Section: Discussionmentioning

confidence: 57%

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Patterns of HIV Diagnosis Disclosure to Infected Children and Family Members: Data from a Paediatric Antiretroviral Program in South Africa

Madiba¹

2012

WJA

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The study examined the patterns of disclosing the HIV diagnosis to infected children and family members, and determined the demographic characteristics associated with disclosure. Semi structured interviews were conducted with caregivers of HIV infected children aged 4 -17 years receiving antiretroviral treatment (ART). A total of 149 caregivers were recruited from a paediatric HIV clinic of a district hospital in South Africa. Caregivers reported that 59 (39.6%) children were told their HIV diagnosis, and majority 36 (61%) were informed of the diagnosis by people other than their biological mothers. Older child age was a determining factor for HIV disclosure to children, 22 (37.2%) learned of their HIV diagnosis between 11 and 16 years. The mean age of disclosed children was 10.6 years. Caregivers took about 3 years after the initial HIV diagnosis to disclose to children, while 143 (99.3%) caregivers reported that disclosure to family members happened immediately after the child's HIV diagnosis. About 28 (31.5%) non-disclosed caregivers planned to disclose to the child between 12 and 18 years, while 13 (14.6%) were not sure about the ideal age to disclose to the child. The lack of consensus regarding the appropriate age for disclosure and the delayed age for future disclosure, suggest that despite increased access to ART for children, there are still significant barriers to disclosing HIV to infected children in this setting. There is a need for health care providers to support caregivers to disclose shortly after diagnosis especially in view of the older age of diagnosis among children enrolled in ART program in this setting.

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 57%

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Patterns of HIV Diagnosis Disclosure to Infected Children and Family Members: Data from a Paediatric Antiretroviral Program in South Africa

Madiba¹

2012

WJA

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“…9 This clearly shows that MTCT is the most common route of transmission. Hence preventive strategies need to be strengthened for preventing MTCT.…”

mentioning

confidence: 94%

“…The increasing number of children orphaned due to HIV/ AIDS is an emerging problem in many developing countries. 9,10,13,15 As the most common route of transmission was vertical (MTCT), the gender distribution of CLHIV should have been almost equal (at least in the same proportion as the sex ratio at birth). Higher proportion of boys (62.7%) could be due to low level of care and lower utilization of services for the infected girls.HIV infection in children is primarily restricted to perinatal transmission or is transfusion acquired.…”

mentioning

confidence: 99%

Clinico-Social and Immunological Profile of Antiretroviral Naïve Children Living With HIV In Tertiary Care Hospital, Delhi

Verma

Acharya

Bachani

et al. 2017

SAARC J. Tuber. Lung Dis. HIV/AIDS

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introduction: This study was undertaken to assess the clinical profile of children living with HIV at the time of their enrolment in an ART centre in Delhi. The study also attempts to understand association between clinical staging and immunological profile (CD4 count/percentage) in HIV infected children. The findings of this study may help policy makers to plan better health care of CLHIV in resource constrained country like India. The Objectives of the study were to assess the baseline clinico-social and immunological profile of HIV positive children before the start of Antiretroviral Therapy, to study clinicosocial and morbidity profile of HIV positive children at the time of their enrolment in ART centre and to study the association between immunodeficiency and clinical staging of CLHIV.

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Models of support for disclosure of HIV status to HIV‐infected children and adolescents in resource‐limited settings

et al. 2018

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IntroductionDisclosure of HIV status to HIV‐infected children and adolescents is a major care challenge. We describe current site characteristics related to disclosure of HIV status in resource‐limited paediatric HIV care settings within the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium.MethodsAn online site assessment survey was conducted across the paediatric HIV care sites within six global regions of IeDEA. A standardized questionnaire was administered to the sites through the REDCap platform.ResultsFrom June 2014 to March 2015, all 180 sites of the IeDEA consortium in 31 countries completed the online survey: 57% were urban, 43% were health centres and 86% were integrated clinics (serving both adults and children). Almost all the sites (98%) reported offering disclosure counselling services. Disclosure counselling was most often provided by counsellors (87% of sites), but also by nurses (77%), physicians (74%), social workers (68%), or other clinicians (65%). It was offered to both caregivers and children in 92% of 177 sites with disclosure counselling. Disclosure resources and procedures varied across geographical regions. Most sites in each region reported performing staff members' training on disclosure (72% to 96% of sites per region), routinely collecting HIV disclosure status (50% to 91%) and involving caregivers in the disclosure process (71% to 100%). A disclosure protocol was available in 14% to 71% of sites. Among the 143 sites (79%) routinely collecting disclosure status process, the main collection method was by asking the caregiver or child (85%) about the child's knowledge of his/her HIV status. Frequency of disclosure status assessment was every three months in 63% of the sites, and 71% stored disclosure status data electronically.ConclusionThe majority of the sites reported offering disclosure counselling services, but educational and social support resources and capacities for data collection varied across regions. Paediatric HIV care sites worldwide still need specific staff members' training on disclosure, development and implementation of guidelines for HIV disclosure, and standardized data collection on this key issue to ensure the long‐term health and wellbeing of HIV‐infected youth.

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Disclosure of the HIV infection status in children

Abstract: There is need to develop and implement guidelines for disclosure of HIV infection status to HIV-infected children in resource limited settings.

Cited by 50 publications

References 14 publications

Patterns of HIV Diagnosis Disclosure to Infected Children and Family Members: Data from a Paediatric Antiretroviral Program in South Africa

Patterns of HIV Diagnosis Disclosure to Infected Children and Family Members: Data from a Paediatric Antiretroviral Program in South Africa

Clinico-Social and Immunological Profile of Antiretroviral Naïve Children Living With HIV In Tertiary Care Hospital, Delhi

Models of support for disclosure of HIV status to HIV‐infected children and adolescents in resource‐limited settings

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