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Disclosure Status and Associated Factors Among Children on Antiretroviral Therapy in Ethiopia

Walelign Atomsa Tucho¹, Aderajew Nigusse Tekelehaimanot², Mahilet Berhanu Habte²

¹Department of Disease Prevention and Control, Bench Sheko Zone Health Office, Mizan-Aman, Southwest Ethiopia.

Pediatric Health, Medicine and Therapeutics

|July 2, 2021

Insights

Disclosure of HIV status to children remains low in Ethiopia. Factors like caregiver education and discussion with health professionals can improve HIV status disclosure rates for children on antiretroviral therapy (ART).

Area of Science:

Pediatrics
Infectious Diseases
Public Health

Background:

The World Health Organization (WHO) recommends HIV status disclosure to children aged 6-12 years.
Disclosure rates are notably low in resource-limited settings, especially in Ethiopia.
This study addresses the low HIV status disclosure among children in southwest Ethiopia.

Purpose of the Study:

To determine the prevalence of HIV status disclosure among HIV-infected children in southwest Ethiopia.
To identify factors associated with HIV status disclosure in this population.

Main Methods:

A facility-based cross-sectional study was conducted with caregivers of HIV-positive children (aged 6-15) in southwest Ethiopia.
Data were collected via interviewer-administered questionnaires and checklists.
Multivariable logistic regression analysis was used to identify predictors of disclosure.

Main Results:

The prevalence of HIV-positive status disclosure was 45.6%.
Independent predictors of disclosure included caregiver secondary education, discussion with health professionals, child age 10-15 years, duration on ART >5 years, hospital treatment follow-up, and having a treatment support group.
Caregiver discussion with health professionals (AOR=9.56) and child age 10-15 years (AOR=3.64) were significant factors.

Conclusions:

HIV status disclosure to children in the study area is low.
Caregiver education, communication with healthcare providers, child's age, ART duration, treatment setting, and support groups are key factors enabling disclosure.
Targeted interventions are needed to improve HIV status disclosure rates among children living with HIV.

Read full analysis

Abstract

Background:

The World Health Organization recommends that children should be informed of their HIV status at age 6-12 years. However, disclosure of HIV status among children is very low in resource-limited areas, particularly in Ethiopia. So, the aim of this study was to determine the prevalence of disclosure and associated factors among a cohort of HIV-infected children in southwest Ethiopia.

Methods:

A facility-based cross-sectional study design was employed among caregivers of HIV-positive children aged 6-15 in Bench sheko and West Omo zone Southwest Ethiopia, from March 1 to April 20, 2020. Study participants were included using a consecutive sampling technique. Data were collected using a pretested interviewer administered questionnaire and checklist. A multivariable logistic regressions model was used to identify independent predictors of disclosure. The significance of association was declared by AOR at 95% confidence and a p-value <0.05.

Results:

A total of 327 participants were involved in the study yielding a 95% response rate. The prevalence of HIV-positive status disclosure was 45.6% (95% CI=41.01-51.02). Caregiver secondary education and above (AOR=3.16, 95% CI=1.07-9.34), caregiver discussed about disclosure with health professionals (AOR= 9.56, 95% CI=4.88-18.74), child age 10-15 year old (AOR=3.64, 95% CI=1.64-8.08), duration on ART >5 years (AOR=5.08, 95% CI=1.57-16.37), treatment follow-up at hospital (AOR=2.23, 95% CI=1.27-5.01) and having treatment support for Children (AOR=3.84, 95% CI=1.88-7.85) were independent predictors of HIV-positive status disclosure.

Conclusion:

Disclosure of HIV status to children is low. Caregivers educational status, caregivers discussion with health professional, older child, duration on ART of more than 5 year, getting treatment service from hospital, and having a treatment support group are factors that enable disclosure. Therefore, concerted efforts based on the findings of this study will be required to improve the disclosure status among HIV-positive children.

Keywords:

antiretroviral therapy child disclosure

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