秘鲁利马儿童、照顾者及医疗服务提供者对于向围产期感染儿童披露艾滋病毒感染状况的观点与经历
Child, Caregiver, and Health Care Provider Perspectives and Experiences Regarding Disclosure of HIV Status to Perinatally Infected Children in Lima, Peru.
作者信息
Baker Amira Noori, Bayer Angela Marie, Kolevic Lenka, Najarro Lizzete, Viani Rolando Mario, Deville Jaime Gerardo
机构信息
1 Department of Pediatrics, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA, USA.
2 Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA, USA.
出版信息
J Int Assoc Provid AIDS Care. 2018 Jan-Dec;17:2325957417752257. doi: 10.1177/2325957417752257.
BACKGROUND
Despite recommendations for disclosure of HIV status to children living with HIV (CLHIV), fewer than half of CLHIV at the Instituto Nacional de Salud del Niño (INSN) in Lima, Peru, have had disclosure. How and when the disclosure process for CLHIV should take place in Peru has not been studied.
METHODS
We conducted a qualitative study at INSN to explore perceptions and experiences of 6 health care providers (HCPs), 14 disclosed and nondisclosed CLHIV (8-17 years), and their 14 caregivers regarding knowledge of illness, disclosure of HIV status, and appropriate disclosure approaches.
RESULTS
Disclosed children wanted to be told their diagnosis earlier. Nondisclosed children expressed frustration taking medications. Caregivers and HCPs discussed motivations to disclose, including educating, honesty, improving medication adherence, and preventing secondary transmission.
CONCLUSION
Culturally appropriate guidelines and training for HCPs and caregivers are needed to support disclosure of children's HIV status and ongoing support for CLHIV.
背景
尽管有建议向感染艾滋病毒的儿童（CLHIV）披露其艾滋病毒感染状况，但在秘鲁利马的国家儿童健康研究所（INSN），只有不到一半的感染艾滋病毒儿童知晓自己的感染状况。在秘鲁，感染艾滋病毒儿童的病情披露过程应如何进行以及何时进行尚未得到研究。
方法
我们在INSN开展了一项定性研究，以探讨6名医疗保健提供者（HCP）、14名已被告知和未被告知感染状况的感染艾滋病毒儿童（8至17岁）及其14名照顾者对疾病知识、艾滋病毒感染状况披露以及适当披露方式的看法和经历。
结果
已被告知病情的儿童希望更早得知自己的诊断结果。未被告知病情的儿童对服药表示沮丧。照顾者和医疗保健提供者讨论了披露病情的动机，包括教育、诚实、提高服药依从性以及防止二次传播。
结论
需要为医疗保健提供者和照顾者制定符合文化背景的指导方针和培训，以支持披露儿童的艾滋病毒感染状况，并为感染艾滋病毒儿童提供持续支持。
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