All Title Author
Keywords Abstract

ISRN AIDS  2012 

HIV-Positive Status Disclosure and Associated Factors among Children in North Gondar, Northwest Ethiopia

DOI: 10.5402/2012/485720

Full-Text   Cite this paper   Add to My Lib


Introduction. Clinical reports have indicated positive outcomes associated with disclosure of HIV-positive status in children. This study assessed the level and associated factors of HIV-positive status disclosure to HIV-infected children in northwest Ethiopia. Methods. Institution-based cross-sectional study was conducted among HIV-positive children from March to April 2012. Data were collected using a structured questionnaire by face-to-face interview technique. Bivariate and multivariate analyses were performed. Results. Of the 428 children, 169 (39.5%) were disclosed their HIV-positive status. The mean age of HIV-positive status disclosure was at 10.7 (±2.3) years. Having a nonbiological parent ( , 95% CI: 1.22, 14.04), child’s age older than 10 years ( , 95% CI: 4.5, 15.53), and death of a family member ( , 95% CI: 1.16, 3.6) were significantly and independently associated with disclosure of HIV-positive status to infected children. Conclusions. The rate of disclosure of HIV-positive status to infected children still remains low in North Gondar. Hence, it is important to target children living with their biological parents and having young parents and children younger than 10 years. The guideline for disclosure of children with HIV/AIDS should be established in an Ethiopian context. 1. Introduction HIV/AIDS is increasingly affecting the health and welfare of children and undermining hard-won gains of child survival in highly affected countries [1]. Recent estimates from the Joint United Nations Programs on HIV/AIDS (UNAIDS) suggest that globally about 2.5 million children younger than 15 years of age are infected with HIV: 90% living in sub-Saharan Africa [2] and about 64,813 living in Ethiopia [3]. Without treatment 75% of HIV-infected children will die before their fifth birthday [4]. As highly active antiretroviral therapy (HAART) becomes increasingly available in low resource settings, infected children are living longer [5]. With increased survival, one of the greatest psychosocial challenges that parents and caregivers of HIV-infected children face is the disclosure of HIV-positive status to their infected children. One of the most difficult issues that families with HIV-infected children face is when and how to talk about HIV to their children. HIV-positive status disclosure to infected children and adolescents should take place in a supportive environment with collaboration and cooperation among caregivers and health care providers. Disclosure is contingent on the caregiver’s acknowledgement of the illness, the readiness to disclose, and


[1]  WHO and UNICEF, “Scale up of HIV-related prevention, diagnosis, care and treatment for infants and children: a programming framework,”, 2008.
[2]  UNAIDS, WHO, and UNICEF, “Towards universal access: scaling up priority HIV/AIDS interventions in the health sector, progress reoprt,” Tech. Rep., UNAIDS, Geneva, Switzerland, 2010.
[3]  FHAPCO and FMoH, Guidelines For Paediatric HIV/AIDS Care and Treatment in Ethiopia, Federal HIV/AIDS Prevention and Control Office Federal Ministry of Health, 2007.
[4]  M. L. Newell, H. Coovadia, M. Cortina-Borja, N. Rollins, P. Gaillard, and F. Dabis, “Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis,” The Lancet, vol. 364, no. 9441, pp. 1236–1243, 2004.
[5]  A. Lesch, L. Swartz, A. Kagee et al., “Paediatric HIV/AIDS disclosure: towards a developmental and process-oriented approach,” AIDS Care, vol. 19, no. 6, pp. 811–816, 2007.
[6]  AIDS institute New York State Department of Health, “HIV clinical resource: disclosure of HIV to perinatally infected children and adolescents,”, 2009.
[7]  S. Kallem, L. Renner, M. Ghebremichael, and E. Paintsil, “Prevalence and pattern of disclosure of HIV status in HIV-infected children in Ghana,” AIDS and Behavior, vol. 15, no. 6, pp. 1121–1127, 2011.
[8]  “Disclosure of illness status to children and adolescents with HIV infection. American academy of pediatrics committee on pediatrics AIDS,” Pediatrics, vol. 103, no. 1, pp. 164–166, 1999.
[9]  D. Jerene, A. N?ss, and B. Lindtj?rn, “Antiretroviral therapy at a district hospital in Ethiopia prevents death and tuberculosis in a cohort of HIV patients,” AIDS Research and Therapy, vol. 3, no. 1, article 10, 2006.
[10]  S. Grubman, E. Gross, N. Lerner-Weiss et al., “Older children and adolescents living with perinatally acquired human immunodeficiency virus infection,” Pediatrics, vol. 95, no. 5, pp. 657–663, 1995.
[11]  J. Cohen, C. Reddington, D. Jacobs et al., “School-related issues among HIV-infected children,” Pediatrics, vol. 100, no. 1, p. E8, 1997.
[12]  E. Flanagan-Klygis, L. F. Ross, J. Lantos, J. Frader, and R. Yogev, “Disclosing the diagnosis of HIV in pediatrics,” Journal of Clinical Ethics, vol. 12, no. 2, pp. 150–157, 2001.
[13]  P. Lester, M. Chesney, M. Cooke et al., “When the time comes to talk about HIV: factors associated with diagnostic disclosure and emotional distress in HIV-infected children,” Journal of Acquired Immune Deficiency Syndromes, vol. 31, no. 3, pp. 309–317, 2002.
[14]  I. Blasini, C. Chantry, C. Cruz et al., “Disclosure model for pediatric patients living with HIV in Puerto Rico: design, implentation, and evaluation,” Journal of Developmental and Behavioral Pediatrics, vol. 25, no. 3, pp. 181–189, 2004.
[15]  P. J. Bachanas, K. A. Kullgren, K. S. Schwartz et al., “Predictors of psychological adjustment in school-age children infected with HIV,” Journal of Pediatric Psychology, vol. 26, no. 6, pp. 343–352, 2001.
[16]  S. Biadgilign, A. Deribew, A. Amberbir, H. R. Escudero, and K. Deribe, “Factors associated with HIV/AIDS diagnostic disclosure to HIV infected children receiving HAART: a multi-center study in Addis Ababa, Ethiopia,” PLoS ONE, vol. 6, no. 3, Article ID e17572, 2011.
[17]  C. A. Mellins, E. Brackis-Cott, C. Dolezal, A. Richards, S. W. Nicholas, and E. J. Abrams, “Patterns of HIV status disclosure to perinatally HIV-infected children and subsequent mental health outcomes,” Clinical Child Psychology and Psychiatry, vol. 7, no. 1, pp. 101–114, 2002.
[18]  G. Kmita and M. Baranska, “The process of disclosure of an HIV/AIDS problem in the family to children—an exploratory study,” Medycyna Wieku Rozwojowego, vol. 8, no. 3, pp. 623–640, 2004.
[19]  P. Oberdorfer, T. Puthanakit, O. Louthrenoo, C. Charnsil, V. Sirisanthana, and T. Sirisanthana, “Disclosure of HIV/AIDS diagnosis to HIV-infected children in Thailand,” Journal of Paediatrics and Child Health, vol. 42, no. 5, pp. 283–288, 2006.
[20]  B. J. Brown, R. E. Oladokun, K. Osinusi, S. Ochigbo, I. F. Adewole, and P. Kanki, “Disclosure of HIV status to infected children in a Nigerian HIV care programme,” AIDS Care, vol. 23, no. 9, pp. 1053–1058, 2011.
[21]  S. W. Ledlie, “Diagnosis disclosure by family caregivers to children who have perinatally acquired HIV disease: when the time comes,” Nursing Research, vol. 48, no. 3, pp. 141–149, 1999.
[22]  L. S. Wiener, H. B. Battles, N. Heilman, C. K. Sigelman, and P. A. Pizzo, “Factors associated with disclosure of diagnosis to children with HIV/AIDS,” Pediatric AIDS and HIV Infection, vol. 7, no. 5, pp. 310–324, 1996.
[23]  R. Bor, “Disclosure. Vancouver conference review,” AIDS Care, vol. 9, no. 1, pp. 49–53, 1997.


comments powered by Disqus