Meta-Analysis of Disclosure Rates of Mothers Infected with HIV to Their Children: A Global Perspective (Preprint)

Abstract

BACKGROUND With the advancement in HIV treatment, the quality of life of HIV-infected women has significantly improved, and HIV-infected women have been able to participate in childcare and assume social responsibilities. Research suggests that there are varying degrees of maternal HIV disclosure among HIV-infected mothers, and that these differences may be related to a variety of psycho-social factors. However, there is a lack of data on the overall disclosure rate. OBJECTIVE The objective of this study was to conduct a comprehensive review and meta-analysis of the global prevalence of disclosure of HIV status to children among HIV-infected mothers, with the aim of establishing a foundation for preventing mother-to-child transmission (PMTCT), enhancing ART adherence among HIV-infected mothers, and improving overall survival quality. METHODS We searched Pub Med, EMBASE, and Cochrane Library in English, and we also specifically searched CNKI, Wanfang Data, and VIP databases in Chinese for the studies of HIV women disclosure in China. Studies that published from January 1, 2003 to 2024 were located. Language restriction is English and Chinese. Key words include “HIV-infected”, “maternal” or “mother” or “women” or “parent”, “children” or “youth” or “adolescents”, and “disclosure” or “inform” . RESULTS Ultimately, 14 studies were included for review. Heterogeneity among the chosen studies was evaluated through chi-square tests and I2 statistics; and sensitivity analyses were conducted to assess the comparability of study results. The global HIV disclosure rate was 41% with a 95%confidence interval (CI) ranging from 30% to 52%. Subgroup analyses based on region and parental infection status showed that the HIV disclosure rate was 36% [95%CI:25%-49%] in 3 Chinese based study; 60% [95%CI:49%-70%] in 6 U.S. based studies; and 25% [95%CI:11%-43%] in 4 African based study. Furthermore, the HIV disclosure rate was 42%[95%CI:28%-57%] among families with only mother being infected with HIV across 9 studies; and 39%[95%CI:22%-59%] among families with both parents being infected across 5 studies. CONCLUSIONS Findings indicate that the disclosure rate of HIV-infected mothers to their children is higher in developed regions, and within families with only mother being infected with HIV. Further research efforts and policy development are imperative to support decision-making processes for HIV-infected mothers when considering disclosure of HIV infection status to their children. CLINICALTRIAL CRD42024531337