Talking to children about their HIV status: a review of available resources, tools, and models for improving and promoting pediatric disclosure

Wright, Sharon; Amzel, Anouk; Ikoro, N.C.; Srivastava, Maya D.; Leclerc‐Madlala, Suzanne; Bowsky, Sara; Miller, Henry S.; Phelps, B. Ryan

doi:10.1080/09540121.2016.1273471

Cited by 20 publications

(22 citation statements)

References 39 publications

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“…WHO has also published the Guideline on HIV Counseling for Children up to 12 years of Age for adaptation in countries ( 5 ). Existing pediatric disclosure models and tools, such as children’s books, videos, job aides, and curricula, aim to assist health care providers, caregivers, and/or children in disclosure ( 37 – 39 ). These models and tools also address some of the health outcomes identified in this review.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Disclosure on Health and Related Outcomes in Human Immunodeficiency Virus-Infected Children: A Literature Review

Odiachi

2017

Front. Public Health

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This review explores the association between pediatric human immunodeficiency virus (HIV) disclosure and health and related outcomes among children living with HIV. A multi-stage process was used to search for relevant articles on the ISI Web of Knowledge database. Fifteen articles met the inclusion criteria. Five major outcomes emerged from children’s knowledge of their HIV-seropositive status: physical/physiological outcomes; adherence to antiretroviral therapy; psychosocial outcomes; sexual and reproductive health, including HIV prevention outcomes; and disclosure of status by the children. Disclosure of a child’s HIV status to the child has value in terms of positive health outcomes for the child, such as better adherence and slower disease progression—albeit the different studies did not always reach the same conclusions, and some suggest negative health outcomes, such as increased psychiatric hospitalization. Yet, there does not seem to be a systematic or coherent system for child disclosure. One recommendation from this review, therefore, is for government and program policies and guidelines that will promote child HIV disclosure in order to address the current low rates of disclosure in sub-Saharan Africa (SSA). More rigorous and longitudinal studies on the outcomes of disclosure, with larger sample sizes, and in SSA, are also needed.

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Section: Discussionmentioning

confidence: 99%

The Impact of Disclosure on Health and Related Outcomes in Human Immunodeficiency Virus-Infected Children: A Literature Review

Odiachi

2017

Front. Public Health

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“…However, some studies included participants who had not yet been told their HIV status. Nondisclosure rates as high as 89% (Tadesse et al., ) complicates findings, since disclosure itself may be a confounding variable (Wright et al., ). Moreover, not all studies focussed on the adolescent age range, with participants as young as 6 years included (Tadesse et al., ).…”

Section: Introductionmentioning

confidence: 99%

Predictors of mental health problems in adolescents living with HIV in Namibia

Gentz

Romano

Martínez-Arias

et al. 2017

Child Adoles Ment Health

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Background Little research in sub‐Saharan Africa has looked at factors that predict mental health problems in adolescents living with HIV (ALHIV). This study examines the psychological impact of HIV in adolescents in Namibia, including risk and protective factors associated with mental health. Methods Ninety‐nine fully disclosed ALHIV between the ages of 12 and 18 were interviewed at a State Hospital in Windhoek. A structured questionnaire assessed mental health, using the SDQ (Goodman, 1997), sociodemographic factors, poverty, social support, adherence and stigma. Results Mean age was 14.3 years, 52.5% were female and most were healthy. Twelve percent scored in the clinical range for total mental health difficulties and 22% for emotional symptoms. Poverty was associated with more total mental health difficulties, t(96) = −2.63, p = .010, and more emotional symptoms, t(96) = −3.45, p = .001, whereas better social support was a protective factor, particularly caregiver support (r = −.337, p = .001). Adherence problems, HIV‐related stigma and disclosing one's own HIV status to others were also associated with more total mental health difficulties. Poverty (β = −.231, p = .023) and stigma (β = .268, p = .009) were the best predictors for total mental health difficulties, whereas stigma (β = .314, p = .002) predicted emotional symptoms. Social support had a protective effect on peer problems (p = .001, β = −.349). Conclusions Several contextual factors associated with poorer mental health in ALHIV are identified.

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“… 13 , 22 , 24 , 25 Similarly, some studies suggest that front-line HCWs also lack the expertise to confidently practise child-centred HIV counseling, help PCGs disclose HIV-seropositive status to children or provide ongoing psychosocial support that addresses treatment adherence and sexual reproductive health. 15 , 20 , 26 , 27 , 28 …”

Section: Introductionmentioning

confidence: 99%

Post-training and mentorship experiences of KidzAlive-trained healthcare workers at primary healthcare facilities in KwaZulu-Natal, South Africa

Mutambo

Shumba

Hlongwana

2020

African Journal of Primary Health Care & Family Medicine

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Background: KidzAlive, a multicomponent, child-centred capacity building model was adopted by South Africa’s National Department of Health to address the challenges of quality of care among HIV+ children. This model involves training and mentoring healthcare workers (HCWs) on a child-centred care approach of communicating with children and their primary caregivers (PCGs). This study explored HCWs’ post-training experiences after a 6-months implementation period.Aim: To evaluate the KidzAlive model as a healthcare approach that seeks to improve the quality of HIV care among children.Setting: The study was conducted in 20 PHC rural and urban facilities across four districts in KwaZulu-Natal.Methods: Interviews were conducted by trained interviewers who followed a structured interview guide. These were audio-recorded, transcribed, and imported into NVivo 10 software for thematic analysis. Thematic analysis was used to develop a coding framework from the participant’s responses.Results: Five themes, namely: (1) increased healthcare worker knowledge, skills and confidence to provide child-friendly HIV services to children; (2) increased involvement of HIV + children in own healthcare journey; (3) the involvement of primary caregivers in children’s healthcare journey; (4) improved health outcomes for HIV + children; and e) transformation of the PHC environment towards being more child-friendly.Conclusion: The findings present preliminary evidence of successful KidzAlive trained HCWs’ buy-in of KidzAlive intervention. KidzAlive has been well integrated into current service delivery processes in PHC facilities. However, more rigorous research is warranted to fully understand the impact of this intervention on children and their primary caregivers.

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Talking to children about their HIV status: a review of available resources, tools, and models for improving and promoting pediatric disclosure

Cited by 20 publications

References 39 publications

The Impact of Disclosure on Health and Related Outcomes in Human Immunodeficiency Virus-Infected Children: A Literature Review

The Impact of Disclosure on Health and Related Outcomes in Human Immunodeficiency Virus-Infected Children: A Literature Review

Predictors of mental health problems in adolescents living with HIV in Namibia

Post-training and mentorship experiences of KidzAlive-trained healthcare workers at primary healthcare facilities in KwaZulu-Natal, South Africa

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