Tsuzuki Shinya, Ishikawa Naoko, Miyamoto Hideki, Dube Christopher, Kayama Nangana, Watala Janet, Mwango Albert
National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
Mumbwa District Community Health Office, Mumbwa, Zambia.
BMC Pediatr. 2018 Aug 18;18(1):272. doi: 10.1186/s12887-018-1252-2.
Care of children living with HIV comprises various issues, some considered challenging. One of the challenging areas is the serostatus disclosure to HIV-positive children. This study describes the current situation of HIV disclosure among rural children in Zambia and examines the socio-demographic factors promoting disclosure.
We used a mixed method approach applying both quantitative and qualitative methods to obtain comprehensive picture of HIV serostatus disclosure for children. Data were collected in Mumbwa district, Zambia (2010-2012), included 57 clinical records of children older than 5 years old. We examined children's age, gender, and cohabitation status with their parents, caregivers' level of education and income, and the relation between children and caregivers. Logistic regression model was applied to examine associations between disclosure and socio-demographic characteristics. Semi-structured interviews with 50 caregivers and 22 HIV-positive children were conducted to qualitatively investigate attitude towards disclosure and support needed.
Full disclosure was completed in 17 out of 57 (29.8%) patients. Median ages of patients in disclosed group and non-disclosed group were 10 and 9, respectively (IQR 8.0-13.0, 7.0-11.25). In univariate analyses, older age and male gender has positive relation to the completion of serostatus disclosure. In logistic regression models, cohabitation status with patients' mothers showed positive correlation to the completion of serostatus disclosure. In the interviews with caregivers, all caregivers said that disclosure of serostatus is a necessary process and good for their children, while actual serostatus disclosure rate was low.
Serostatus disclosure to HIV-seropositive children is not prevalent in Rural Zambia. Although further researches would be desirable, increased support to caregivers would be beneficial.
感染艾滋病毒儿童的护理涉及诸多问题，其中一些颇具挑战性。具有挑战性的领域之一是向艾滋病毒呈阳性的儿童披露血清学状态。本研究描述了赞比亚农村儿童艾滋病毒披露的现状，并探讨了促进披露的社会人口学因素。
我们采用混合方法，运用定量和定性方法，以全面了解儿童艾滋病毒血清学状态披露情况。数据于2010年至2012年在赞比亚蒙布瓦区收集，包括57份5岁以上儿童的临床记录。我们研究了儿童的年龄、性别、与父母的同居状况、照顾者的教育程度和收入，以及儿童与照顾者之间的关系。应用逻辑回归模型来检验披露与社会人口学特征之间的关联。对50名照顾者和22名艾滋病毒呈阳性的儿童进行了半结构化访谈，以定性调查对披露的态度和所需支持。
57名患者中有17名（29.8%）完成了完全披露。披露组和未披露组患者的中位年龄分别为10岁和9岁（四分位间距8.0 - 13.0，7.0 - 11.25）。在单因素分析中，年龄较大和男性与血清学状态披露的完成呈正相关。在逻辑回归模型中，与患者母亲的同居状况与血清学状态披露的完成呈正相关。在对照顾者的访谈中，所有照顾者都表示披露血清学状态是一个必要的过程，对他们的孩子有好处，但实际血清学状态披露率较低。
在赞比亚农村，向艾滋病毒血清呈阳性的儿童披露血清学状态并不普遍。尽管需要进一步研究，但增加对照顾者的支持将是有益的。
