Département de Recherche Clinique, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
Service universitaire de psychiatrie de l'enfant et de l'adolescent (SUPEA), CHU de Toulouse.
Curr Opin HIV AIDS. 2018 May;13(3):220-229. doi: 10.1097/COH.0000000000000462.
Improved access to antiretroviral therapy has resulted in an emerging population of adolescents living with HIV (ALHIV) mainly in sub-Saharan Africa. Full disclosure of an HIV diagnosis includes naming HIV/AIDS and is an important step in coping with HIV. We reviewed the recent trends in the rates of children/adolescents who have been informed of their HIV infection according to age groups, the barriers and the evaluated interventions aimed at improving the HIV disclosure process to ALHIV in sub-Saharan Africa.
Literature shows that HIV disclosure remains challenging in sub-Saharan Africa. Although full HIV disclosure rates have increased recently, this is still insufficient and occurs at a late age (median 13 years). Individual disclosure is the main practice but group sessions involving adolescent peers also exist. The practice of the disclosure is often complex, because of multiple barriers related to caregivers (fear of the parents of the breaking of the family secrecy, feelings of guilt) and to healthcare workers (lack of training, excess workload).
The development and evaluation of research interventions adapted to sociocultural contexts to support timely and safe HIV disclosure to ALHIV is urgently needed to reach the 90-90-90 UNAIDS targets.
综述目的：抗逆转录病毒疗法的可及性提高，导致撒哈拉以南非洲地区出现了大量主要由青少年组成的艾滋病毒感染者（ALHIV）。艾滋病毒诊断的完全披露包括艾滋病毒/艾滋病的名称，这是应对艾滋病毒的重要一步。我们回顾了根据年龄组，告知儿童/青少年其艾滋病毒感染情况的最新趋势，以及在撒哈拉以南非洲地区改善艾滋病毒披露过程以帮助 ALHIV 的障碍和评估干预措施。
最新发现：文献表明，艾滋病毒披露在撒哈拉以南非洲地区仍然具有挑战性。尽管最近艾滋病毒完全披露率有所提高，但这仍然不足，而且发生在较晚的年龄（中位数为 13 岁）。个体披露是主要做法，但也存在涉及青少年同伴的小组会议。披露实践通常很复杂，因为与照顾者有关的多种障碍（父母打破家庭秘密的恐惧、内疚感）和与医疗保健工作者有关的障碍（缺乏培训、工作量过大）。
总结：迫切需要制定和评估适应社会文化背景的研究干预措施，以支持及时、安全地向 ALHIV 披露艾滋病毒，以实现联合国艾滋病规划署的 90-90-90 目标。
