Shallo Seifadin Ahmed, Tassew Mesfin
Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
Department of Pediatrics and Child Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
J Multidiscip Healthc. 2020 Jun 16;13:507-517. doi: 10.2147/JMDH.S258851. eCollection 2020.
Evidence from previous studies supports the idea that informing children about their HIV status has long-term positive implications in HIV disease management, children's quality of life, and ART drug adherence. However, in sub-Saharan African Countries, the HIV status disclosure among children ranges from 0% to 69.2%. So it is important to investigate the up to date evidence that will help in designing contextualized approaches for disclosure. Therefore, this study aimed to assess the HIV status disclosure and its associated factors among children on ART in West Shoa Zone, Ethiopia.
Institutional-based observational study was conducted from February to April 2019. Quantitative data were collected from a randomly selected sample of 247 HIV positive children on ART for the last six months, and the qualitative data were collected from caregivers and health care professionals.
The mean age of the children was 11.11±SD2.8, and 43.6%, (95% CI: 37, 50.9) of the children were fully disclosed. The average age at disclosure was 11±SD2.12. The main reasons for the disclosure were for drug adherence and better self-care while being underage was the commonest reason for non-disclosure. Compared to the age 10-15 years, the child in the age 6-9 was 97% [AOR: 0.027, 95% CI: 0.003, 0.22, P<0.001] less likely to be disclosed. Female children were 2.7 times more likely to be disclosed compared with male children [AOR: 2.73, 95% CI: 1.24, 6, P<0.013].
This finding reveals that HIV status disclosure is generally low, and the decision to disclose or not is affected by factors like child-related, caregivers, and health institution-related factors. This may affect the child's drug adherence, treatment outcome, and disease transmission. Updating health care providers' knowledge and skills and working on caregivers' attitude are needed to manage disclosure and challenges following it.
以往研究的证据支持这样一种观点，即告知儿童其艾滋病毒感染状况对艾滋病毒疾病管理、儿童生活质量和抗逆转录病毒治疗药物依从性具有长期积极影响。然而，在撒哈拉以南非洲国家，儿童艾滋病毒感染状况的披露率从0%到69.2%不等。因此，调查有助于设计因地制宜的披露方法的最新证据很重要。因此，本研究旨在评估埃塞俄比亚西绍阿地区接受抗逆转录病毒治疗的儿童的艾滋病毒感染状况披露情况及其相关因素。
2019年2月至4月进行了基于机构的观察性研究。定量数据收集自过去六个月中随机抽取的247名接受抗逆转录病毒治疗的艾滋病毒阳性儿童，定性数据收集自照顾者和医护人员。
儿童的平均年龄为11.11±标准差2.8岁，43.6%（95%置信区间：37，50.9）的儿童已完全被告知。披露的平均年龄为11±标准差2.12岁。披露的主要原因是为了提高药物依从性和更好地自我护理，而未达到法定年龄是未披露的最常见原因。与10 - 15岁的儿童相比，6 - 9岁的儿童被告知的可能性低97%[调整后比值比：0.027，95%置信区间：0.003，0.22，P<0.001]。女童被告知的可能性是男童的2.7倍[调整后比值比：2.73，95%置信区间：1.24，6，P<0.013]。
这一发现表明，艾滋病毒感染状况的披露率普遍较低，披露与否的决定受儿童相关、照顾者和卫生机构相关因素等影响。这可能会影响儿童的药物依从性、治疗效果和疾病传播。需要更新医护人员的知识和技能，并改善照顾者的态度，以应对披露及其带来的挑战。
