HIV disclosure and its effect on treatment outcomes in perinatal HIV-infected Thai children

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• The World Health Organization (WHO) recommends disclosing HIV status to children aged 6-12 years.
• Perinatal HIV infection requires ongoing management and psychosocial support for affected children.
• Timely disclosure of HIV status is crucial for a child's understanding and adherence to treatment.

Purpose of the Study:

• To assess the rate of HIV status disclosure among perinatal HIV-infected Thai children aged 6 years and older.
• To evaluate the association between HIV status disclosure and antiretroviral therapy (ART) adherence, and immunological/virological outcomes.
• To identify factors associated with HIV status disclosure in this population.

Main Methods:

• Cross-sectional study involving primary caregivers of 260 HIV-infected Thai children (≥6 years).
• Data collection included caregiver interviews for disclosure rates and pill counts for ART adherence every three months.
• Immunological (CD4) and virological (HIV-RNA) markers were assessed every six months.

Main Results:

• The median age of HIV status disclosure was 14.8 years.
• Disclosure rates were 21% for children aged 6-12 years and 84% for those older than 12 years.
• No significant differences in ART adherence, CD4 counts, or HIV-RNA levels were observed between disclosed and undisclosed children aged 6-12 years.
• Factors associated with disclosure included age ≥12 years (OR 17.8) and current CD4 count ≤30% (OR 2.09).

Conclusions:

• A significant gap exists in disclosing HIV status to children aged 6-12 years, falling short of WHO recommendations.
• Older age (≥12 years) and lower CD4 percentage were associated with higher likelihood of disclosure.
• HIV status disclosure did not appear to negatively impact ART adherence or clinical outcomes in Thai children with HIV.