HIV-positive status disclosure and associated factors among children in public health facilities in Dire Dawa, Eastern Ethiopia: A cross-sectional study

Guta, Alemu; Areri, Habtamu Abera; Anteab, Kirubel; Abera, Legesse; Umer, Abdurezak Adem

doi:10.1371/journal.pone.0239767

Cited by 9 publications

(11 citation statements)

References 20 publications

(42 reference statements)

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“…Among APHIV, prevalence of disclosure increased with age [ 12 , 14 , 15 ]. Other factors associated with disclosure include female gender, imminent onset of sexual debut, awareness of caregiver's HIV‐positive status and higher levels of caregiver education [ 12 , 16 , 17 , 18 ]. In contrast, reasons reported by caregivers for non‐disclosure include the child's young age, fear of disclosure's negative mental health consequences, risk of stigma if parents’ status is unmasked by child and unclear disclosure guidelines [ 9 , 10 , 14 , 15 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors and consequences of HIV status disclosure to adolescents living with HIV in Eastern Cape, South Africa: a prospective cohort study

et al. 2022

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Introduction The World Health Organization recommends full disclosure of HIV‐positive status to adolescents who acquired HIV perinatally (APHIV) by age 12. However, even among adolescents (aged 10–19) already on antiretroviral therapy (ART), disclosure rates are low. Caregivers often report the child being too young and fear of disclosure worsening adolescents’ mental health as reasons for non‐disclosure. We aimed to identify the predictors of disclosure and the association of disclosure with adherence, viral suppression and mental health outcomes among adolescents in sub‐Saharan Africa. Methods Analyses included three rounds (2014–2018) of data collected among a closed cohort of adolescents living with HIV in Eastern Cape, South Africa. We used logistic regression with respondent random‐effects to identify factors associated with disclosure, and assess differences in ART adherence, viral suppression and mental health symptoms between adolescents by disclosure status. We also explored differences in the change in mental health symptoms and adherence between study rounds and disclosure groups with logistic regression. Results Eight hundred and thirteen APHIV were interviewed at baseline, of whom 769 (94.6%) and 729 (89.7%) were interviewed at the second and third rounds, respectively. The proportion aware of their HIV‐positive status increased from 63.1% at the first round to 85.5% by the third round. Older age (adjusted odds ratio [aOR]: 1.27; 1.08–1.48) and living in an urban location (aOR: 2.85; 1.72–4.73) were associated with disclosure between interviews. There was no association between awareness of HIV‐positive status and ART adherence, viral suppression or mental health symptoms among all APHIV interviewed. However, among APHIV not aware of their status at baseline, adherence decreased at the second round among those who were disclosed to ( N = 131) and increased among those not disclosed to ( N = 151) (interaction aOR: 0.39; 0.19–0.80). There was no significant difference in the change in mental health symptoms between study rounds and disclosure groups. Conclusions Awareness of HIV‐positive status was not associated with higher rates of mental health symptoms, or lower rates of viral suppression among adolescents. Disclosure was not associated with worse mental health. These findings support the recommendation for timely disclosure to APHIV; however, adherence support post‐disclosure is important.

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Section: Introductionmentioning

confidence: 99%

Predictors and consequences of HIV status disclosure to adolescents living with HIV in Eastern Cape, South Africa: a prospective cohort study

et al. 2022

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“…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%

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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“…It is consistent with a study done in Uganda which showed 56% in Jinja Hospital 6 and the study conducted in Dire Dawa showed 60.6%. 18 The possible explanation could be due to the same segment study population in which the study was conducted. However, the finding of this study was higher than the study conducted around Bale zone (28.5%), 17 Tanzania (32.6%), 3 Central Region of Ghana (23.3%), 19 and in Odi district (40%).…”

Section: Discussionmentioning

confidence: 99%

“…This finding is similar to a study done in East Gojjem, Gondar town, Bale, and Dire Dawa. 10 , 12 , 17 , 18 …”

Section: Discussionmentioning

confidence: 99%

Disclosure status of HIV-positive children and associated factors among children in public health facilities in East Arsi zone, Oromia regional state, South Eastern Ethiopia: A cross-sectional study

et al. 2022

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Objectives: This study aims to assess the disclosure status of HIV-positive children and its associated factors in selected hospitals in East Arsi zone, Oromia regional state, Ethiopia, 2020. Methods: Institutional-based cross-sectional study design was conducted on 410 sample size. Four hospitals were randomly selected among hospitals that currently gave service. Data were collected from caregivers/biological parents by interviewing from 30 July 2020 to 30 August 2020 using the systematic random sampling technique. In logistic regression analysis, the variables which had independent correlations with dependent variable were identified based on adjusted odds ratio and a p value <0.05 with 95% confidence interval was claimed as statistically significant. Results: Disclosure status of HIV-positive children was 59.8%, 95% confidence interval (54.9, 64.1). Children diagnosed at the age of <5 (adjusted odds ratio = 0.25, 95% confidence interval (0.126, 0.49)), antiretroviral therapy follow-up for 6–15 years (adjusted odds ratio = 2.08, 95% confidence interval (1.013, 4.29)), children diagnosed at the appropriate age of ⩾12 years (adjusted odds ratio = 1.95, 95% confidence interval (1.09, 3.49)), and children diagnosed at the age of <11 years (adjusted odds ratio = 4.5, 95% confidence interval (3.45, 8.38)) were positively associated factors to disclose status. Conclusion: The disclosure status of HIV-positive children was low in this study. Antiretroviral therapy follow-up for 6–15 years, children diagnosed at the appropriate age of ⩾12 years, children diagnosed at the age of <5 years, and children who aged below 11 years were positively associated with disclosure status. Thus, we recommended, health care providers and all stakeholders should give age-appropriate counseling regarding when and why to disclose their status.

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HIV-positive status disclosure and associated factors among children in public health facilities in Dire Dawa, Eastern Ethiopia: A cross-sectional study

Cited by 9 publications

References 20 publications

Predictors and consequences of HIV status disclosure to adolescents living with HIV in Eastern Cape, South Africa: a prospective cohort study

Predictors and consequences of HIV status disclosure to adolescents living with HIV in Eastern Cape, South Africa: a prospective cohort study

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

Disclosure status of HIV-positive children and associated factors among children in public health facilities in East Arsi zone, Oromia regional state, South Eastern Ethiopia: A cross-sectional study

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