The Prevalence of Disclosure of HIV Status to HIV-Infected Children in Western Kenya

Turissini, Matthew; Nyandiko, Winstone; Ayaya, Samuel; Marete, Irene; Mwangi, Ann; Chemboi, Victor; Warui, Lucy; Vreeman, Rachel C.

doi:10.1093/jpids/pit024

Cited by 36 publications

(42 citation statements)

References 30 publications

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“…Early disclosure is more appropriate than immediate and unplanned disclosure upon entrance into the adult clinic, and also helps to reduce HIV transmission [9]. The prevalence of pediatric HIV disclosure to infected children varies widely throughout the world.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Disclosure of diagnosis to HIV-infected children and adolescents is a challenge worldwide (Turissini et al, 2013;Wiener, Mellins, Marhefka, & Haven, 2007) and is frequently postponed due to allegations of child's immaturity, fears that the child may tell others and feelings of guilt for having infected the child (Guerra & Seidl, 2009). In most cases, events such as schooling, drafting into the military, beginning of working careers or debut of sexual life trigger the process of (un)-planned disclosure:…”

Section: Resultsmentioning

confidence: 99%

“…In Brazil, adolescents frequently do not receive information about their diagnosis/status, although paediatric guidelines emphasise the importance of this process (Brasil, 2009; Committee on Pediatric AIDS, 1999; Programa Estadual DST/Aids CRT DST/Aids-SP, 2008; Turissini et al, 2013;Wiener et al, 2007).…”

Section: Resultsmentioning

confidence: 99%

The “moral career” of perinatally HIV-infected children: revisiting Goffman's concept

et al. 2014

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HIV-infected children usually live in vulnerable situations, experiencing discrimination and stigma commonly felt by other people living with HIV/AIDS. The present study aims to analyse primary socialisation of HIV-infected children and adolescents recruited from a public health service in Rio de Janeiro (Brazil) as a social process that shapes a new generation of stigmatised and vulnerable persons. Research was informed by an interactionist perspective, focusing on key aspects of HIV-infected children and adolescents life histories under the conceptual frame of Erving Goffman's theories regarding "moral careers". Goffman defines the making of a moral career as the process through which a person learns that she/he possesses a particular attribute, which may lead her/him to be discredited by members of the surrounding society. We have identified aspects of life histories of HIV-vertically infected children and adolescents for each aspect of "moral career" as described by Goffman, relating them to as family structure, the experience of living HIV within the family, and the position and family role of a given subject. The patterns of "moral career" proposed by Goffman in 1963 were useful in identifying components of HIV-related stigma among children and adolescents. These include gender and social disadvantages, difficulty in coping with a child with a potentially severe disease, orphanhood, abandonment, adoption and disclosure of one's HIV serostatus. Primary socialisation of HIV-infected children and adolescents is a key piece of the complex HIV/AIDS-labelling process that could be targeted by interventions aiming to decrease stigma and marginalisation. Health care workers and stakeholders should be committed to ensuring education and guaranteeing the legal rights of this specific population, including the continuous provision of quality health care, full access to school and support to full disclosure of HIV diagnosis.

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“…HIV disclosure studies in SSA have centered on telling infected children about their own HIV statuses (Bikaako-Kajura et al, 2006;Brown et al, 2011;Kallem et al, 2011;Menon et al, 2007;Moodley et al, 2006;Vaz et al, 2010;Vreeman et al, 2014); a few have focused on telling children about their parents' HIV statuses (Madiba & Matlala, 2012;Nam et al, 2009;Palin et al, 2009;Rochat et al, 2013;Rwemisisi et al, 2007). Recent studies on disclosure to HIV-positive children have revealed HIV disclosure rates between 11% and 26% in Kenya (John-Stewart et al, 2013;Turissini et al, 2013;Vreeman et al, 2014) and between 17% and 40% in other SSA countries (Biadgilign et al, 2011;Bikaako-Kajura et al, 2006;-Fetzer et al, 2011;Kallem et al, 2011;Madiba, 2012;Menon et al, 2007). Research suggests that the typical age ranges of HIV-positive children receiving full disclosure of their own HIV statuses was between 3 and 19 years in Kenya (Vreeman et al, 2014); 8 and 18 years in the Democratic Republic of Congo (Vaz et al, 2010;Vaz et al, 2008); and 5 and 15 years in South Africa (Heeren et al, 2012;Moodley et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya

Gachanja

Burkholder

Ferraro

2014

Preprint

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HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIVpositive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at five years with full disclosure delivered at 10 years when the child was capable of understanding the illness, or by 14 years when the child was mature enough to receive the news if full disclosure had not been conducted earlier. Important considerations at the time of full disclosure included the parent's and/or child's health statuses, number of infected family members' illnesses to be disclosed to the child, child's maturity and understanding level, and the person best suited to deliver full disclosure to the child. The results also revealed it was important to address important life events such as taking a national school examination during disclosure planning and delivery.Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs in resource-poor nations with high HIV prevalence.

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The Prevalence of Disclosure of HIV Status to HIV-Infected Children in Western Kenya

Abstract: Rates of informing children in western Kenya of their HIV status are low, even among older children. Guiding families through developmentally appropriate disclosure processes should be a key facet of long-term pediatric HIV management.

Cited by 36 publications

References 30 publications

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

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

The “moral career” of perinatally HIV-infected children: revisiting Goffman's concept

HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya

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