Abstract
With the advent of highly active antiretroviral therapy (HAART) HIV-infected children are surviving into adulthood. Despite emerging evidence of the benefits of disclosure, when and how to disclose the diagnosis of HIV to children remain a clinical dilemma. We investigated the prevalence and determinants of HIV disclosure in a cross-sectional study of 71 caregiver-child dyads from the Pediatric HIV/AIDS Care Program at Korle-Bu Teaching Hospital (Accra, Ghana). The children were between 8 and 14 years of age (median age, 10.39 years). The prevalence of disclosure was 21%. In the unadjusted analyses, the age of child, the level of education of child, deceased biologic father, administration of own HIV medications, and longer duration on HIV medication were significantly associated with disclosure. The low prevalence of disclosure underscores the need for a systematic and a staged approach in disclosing HIV status to infected children in resource limited countries.
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Report on the global AIDS epidemic; executive summary: Joint United Nations Programme on HIV/AIDS, 2008. http://data.unaids.org/pub/GlobalReport/2008/JC1511_GR08_ExecutiveSummary_en.pdf. Accessed on 13 Nov 2009.
Wiener L, Mellins CA, Marhefka S, Battles HB. Disclosure of an HIV diagnosis to children: history, current research, and future directions. J Dev Behav Pediatr. 2007;28:155–66.
Butler AM, Williams PL, Howland LC, Storm D, Hutton N, Seage GR III. Impact of disclosure of HIV infection on health-related quality of life among children and adolescents with HIV infection. Pediatrics. 2009;123:935–43.
Menon A, Glazebrook C, Campain N, Ngoma M. Mental health and disclosure of HIV status in Zambian adolescents with HIV infection: implications for peer-support programs. J Acquir Immune Defic Syndr. 2007;46:349–54.
Ferris M, Burau K, Schweitzer AM, et al. The influence of disclosure of HIV diagnosis on time to disease progression in a cohort of Romanian children and teens. AIDS Care. 2007;19:1088–94.
American Academy of Pediatrics Committee on Pediatrics AIDS. Disclosure of illness status to children and adolescents with HIV infection. Pediatrics. 1999;103:164–6.
Grubman S, Gross E, Lerner-Weiss N, et al. Older children and adolescents living with perinatally acquired human immunodeficiency virus infection. Pediatrics. 1995;95:657–63.
Thorne C, Newell ML, Peckham CS. Disclosure of diagnosis and planning for the future in HIV-affected families in Europe. Child Care Health Dev. 2000;26:29–40.
Instone SL. Perceptions of children with HIV infection when not told for so long: implications for diagnosis disclosure. J Pediatr Health Care. 2000;14:235–43.
Oberdorfer P, Puthanakit T, Louthrenoo O, Charnsil C, Sirisanthana V, Sirisanthana T. Disclosure of HIV/AIDS diagnosis to HIV-infected children in Thailand. J Paediatr Child Health. 2006;42:283–8.
Vaz L, Corneli A, Dulyx J, et al. The process of HIV status disclosure to HIV-positive youth in Kinshasa, Democratic Republic of the Congo. AIDS Care. 2008;20:842–52.
Bikaako-Kajura W, Luyirika E, Purcell DW, et al. Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda. AIDS Behav. 2006;10:S85–93.
Bachanas PJ, Kullgren KA, Schwartz KS, et al. Predictors of psychological adjustment in school-age children infected with HIV. J Pediatr Psychol. 2001;26:343–52.
Lester P, Chesney M, Cooke M, et al. When the time comes to talk about HIV: factors associated with diagnostic disclosure and emotional distress in HIV-infected children. J Acquir Immune Defic Syndr. 2002;31:309–17.
Waugh S. Parental views on disclosure of diagnosis to their HIV-positive children. AIDS Care. 2003;15:169–76.
Cohen J, Reddington C, Jacobs D, et al. School-related issues among HIV-infected children. Pediatrics. 1997;100:E8.
Bor R. Disclosure. Vancouver conference review. AIDS Care. 1997;9:49–53.
Lee CL, Johann-Liang R. Disclosure of the diagnosis of HIV/AIDS to children born of HIV-infected mothers. AIDS Patient Care STDS. 1999;13:41–5.
Funck-Brentano I, Costagliola D, Seibel N, Straub E, Tardieu M, Blanche S. Patterns of disclosure and perceptions of the human immunodeficiency virus in infected elementary school-age children. Arch Pediatr Adolesc Med. 1997;151:978–85.
Schonfeld DJ. Talking with elementary school-age children about AIDS and death: principles and guidelines for school nurses. J Sch Nurs. 1996;12:26–32.
Acknowledgments
We are grateful to the Pediatric HIV/AIDS Care Program team at Korle-Bu Teaching Hospital, and Mr. Kakra Adjei and Jonas Kusah for their technical support. We thank the children and families for their participation. The Pediatric HIV/AIDS Care Program is supported by funding from the Korle-Bu Teaching Hospital, the Ministry of Health and the National AIDS Control Program through the Global Fund for AIDS, TB, and Malaria. SK was supported by Down’s International Travel Fellowship and Yale School of Medicine Student Research Fellowship and EP was supported by a grant from the National Institute of Allergy and Infectious Disease (KO8AI074404).
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Stacey Kallem and Lorna Renner contributed equally to this work.
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Kallem, S., Renner, L., Ghebremichael, M. et al. Prevalence and Pattern of Disclosure of HIV Status in HIV-Infected Children in Ghana. AIDS Behav 15, 1121–1127 (2011). https://doi.org/10.1007/s10461-010-9741-9
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DOI: https://doi.org/10.1007/s10461-010-9741-9