Human immunodeficiency virus infection disclosure status to infected school aged children and associated factors in bale zone, Southeast Ethiopia: cross sectional study

Abstract

BackgroundHuman immunodeficiency virus (HIV) positive status disclosure is an essential component of Pediatric care and long term disease management. Children have a right to know their HIV diagnosis result. However, Pediatric HIV disclosure is complex and varies in different communities. This study aimed to assess the prevalence of HIV-positive status disclosure to infected children and associated factors among caregivers of infected children.MethodologyA facility based mixed methods research design study was conducted in Bale Zone of South East Ethiopia. Randomly selected caregivers of HIV-positive children were interviewed using structured questionnaires for quantitative study and 17 in-depth interviews of health care workers and caregivers were conducted for qualitative data. Content analysis was done for qualitative data and logistic regression analysis was used to see the association between different variables and HIV-positive disclosure status. Odds ratio with 95% CI was computed to determine the presence and strength of the associated factors.ResultsA total of 200 caregivers of school aged (6–14 years) children participated in the study. Only 57 (28.5%) of the care givers disclosed HIV-positive status to the child for whom they were caring. The main reason for disclosure delay was due to fear of negative consequences, perception on maturity of the child, and fear of social rejection and stigma. Having social support [AOR = 2.7, 95% CI: (1.1–6.4)], caring for a child between 10 and 14 years with HIV [AOR = 6.5, 95% CI: (2.1–20.2)], a child diagnosed with HIV at age > 5 years [AOR = 2.8, 95% CI: (1.1–7.1)], and children on antiretroviral therapy (ART) with follow-up for > 5 years [AOR = 4.7, 95% CI: (1.8–11.2)] had significant association with HIV- positive status disclosure to infected children.ConclusionThe frequency of HIV infection disclosure to infected children was very low in our cohort. Having social support, having an older child with HIV, a long period of ART follow-up and HIV diagnosis after age of five years were positively associated with HIV-positive status disclosure to infected children. Giving age appropriate counselling to children, social support to the caregivers and working on related factors are very important to improve the observed low disclosure status.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1336-z) contains supplementary material, which is available to authorized users.

Magnitude and Associated Factors of Virological Failure Among Children on ART in Bahir Dar Town Public Health Facilities, Northwest Ethiopia: a Facility Based Cross-sectional Study

“…This nding is in agreement with other previous studies done in Swaziland ( 17), African and Asian children (18), Tanzania (19), and Zimbabwe (20). This could be explained by the fact that children initiating ART at their younger age are more likely to have an immature immune system, which causes rapid disease progression contrasted with a comparative group (21).Additionally, HIV-status disclosure is the most important factor for positive treatment outcomes (22,23). However, in our study, HIV-status disclosure among children aged less than 10 years was very low.…”

Magnitude and associated factors of virological failure among children on ART in Bahir Dar Town public health facilities, Northwest Ethiopia: a facility based cross-sectional study

“…This could be explained by the fact that children initiating ART at their younger age are more likely to have an immature immune system, which causes rapid disease progression contrasted with a comparative group [ 22 ]. Additionally, HIV-status disclosure is the most important factor for positive treatment outcomes [ 23 , 24 ]. However, in our study, HIV-status disclosure among children aged less than 10 years was very low.…”

Caregiver and child factors predicting HIV status disclosure among children enrolled on ART: a cross-regional study in Addis Ababa and Oromia, Ethiopia

“…Being a single caregiver might include less social support. Good social support has previously been proven to be positively associated with disclosure (Lencha et al, 2018). This suggests that caregivers who are divorced/separated may need additional support from the health-care system and society.…”

“…Previous studies have shown that one major reason why caregivers choose not to tell their children is that they feel the child is too young to know about its status (Lencha et al, 2018). The older the children are, the greater is also the likelihood they have been informed.…”

“…In Ethiopia, there were an estimated 62,000 children living with HIV in 2016, of whom about 3800 were children who had been newly infected, and an estimated 2800 died due to HIV (Ethiopia HIV Country Profile, 2016). A study from 2018 where 200 caregivers of school-aged children (6-14 years) with HIV in Ethiopia were interviewed about whether they had disclosed their child's HIV status to the infected child, showed that only 28% had disclosed the status to the child (Lencha et al, 2018).…”