Factors associated with HIV-status disclosure to HIV-infected children receiving care at Kilimanjaro Christian Medical Centre in Moshi, Tanzania

Abstract

INTRODUCTION: With the introduction of antiretroviral drugs HIV-infected children live longer. Disclosure of HIV diagnosis is increasingly an important and inevitable issue. Both healthcare providers and caregivers face challenges of disclosure to children. The objective of this study was to explore factors associated with HIV-status disclosure to HIV-infected children receiving care at Kilimanjaro Christian Medical Centre (KCMC). METHODS: A cross-sectional hospital-based study was conducted from October 2011 to April 2012. Study population included HIV-infected children aged 5 to 14 years, their caregivers and healthcare providers. Structured questionnaires were used to collect information. Children were asked the reason for hospital visits. Outcome of interest was HIV disclosure status. Data was processed and analysed using SPSS version 16.0. Multivariate logistic regression at 5% margin error was used to account for confounders. RESULTS: A total of 211 children were enrolled with mean age of 9.7 (SD 2.6; range 5-14) years. Only 47 (22.3%) children knew their HIV-status. The mean age of disclosure was 10.6 years. Most of disclosed children were aged above 10 years (p=0.001) and self-supervised in taking medication (OR 33.1; 95% CI 13.9-78.9). Children who got other support were more likely to be disclosed than those who did not (OR 2.4; 95% CI 1.1-5.0) while parents/caregivers who discussed with healthcare providers about disclosure did disclose HIV-status more often to their children (OR 4.4; 95% CI 2.2-8.7). CONCLUSION: Most of children were not disclosed. Ages, self medication, getting other support and parents/caregivers prior discussion were strong predictors of disclosure status.

Keywords

• paediatric hiv
• hiv disclosure status
• parents
• caregivers