Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.
College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2020 Oct 12;15(10):e0239767. doi: 10.1371/journal.pone.0239767. eCollection 2020.
HIV status disclosure in children is one of acontroversial issue in current health. Over 44,000 children in Ethiopia were living with HIV in the year 2019 with a variable level of disclosure, which ranges from 16.3% to 49%. Therefore, this study aimed to assess HIV-positive status disclosure and associated factors among HIV-infected children.
A cross-sectional study was conducted in ten public health facilities providing pediatric antiretroviral therapy services. Systematic random sampling was used to select 221 caregivers of children aged 6-15 years. Face-to-face interviews were employed to generate the data. Binary logistic regression was used to analyze the association between HIV-positive status disclosure to children and independent variables with statistical significance set at p-value <0.05.
Out of the total, 134 (60.6%) of HIV-infected children knew about their HIV status. The mean age at disclosure was 10.71 years. Children aged older than 10 years [AOR = 22, 95% CI: 5.3-79.2], female children [AOR = 3; 95% CI = 1.2-8.7], children lost their family member by HIV [AOR = 3.5, 95% CI: 1.2-10], caregiver's perception of child did not get stigmatized [AOR = 4, 95% CI: 1.6-11], and children's responsible for anti-retroviral therapy [AOR = 16, 95% CI: 5-50] were significantly associated with HIV positive status disclosure compared to their counterpart respectively. Children who stayed on anti-retroviral for 10-15 years were [AOR = 7; 95% CI: 2-27] more likely to know their HIV positive status compared to those staying on anti-retroviral therapy for <6 years.
The proportion of disclosure of HIV-positive status among HIV-infected children was low. Factors associated were the age of the child, sex, existence of parent, stigma, ART duration, and responsibility of the child for his/her drugs. HIV care providers should consider these factors while supporting disclosure.
在当前的健康领域，HIV 感染者向儿童披露其 HIV 状况是一个备受争议的问题。2019 年，埃塞俄比亚有超过 44000 名儿童携带 HIV，披露率存在差异，范围从 16.3%到 49%不等。因此，本研究旨在评估 HIV 阳性儿童的 HIV 阳性状况披露情况及其相关因素。
本研究采用横断面研究设计，在 10 家提供儿科抗逆转录病毒治疗服务的公共卫生机构中进行。采用系统随机抽样方法选取了 221 名年龄在 6-15 岁之间的儿童照顾者。采用面对面访谈的方式收集数据。采用二元逻辑回归分析 HIV 阳性状况向儿童披露与独立变量之间的关联，具有统计学意义的 p 值设定为<0.05。
在总共 221 名 HIV 感染者中，有 134 名（60.6%）儿童知晓其 HIV 状况。披露的平均年龄为 10.71 岁。年龄大于 10 岁的儿童[比值比（OR）=22，95%置信区间（CI）：5.3-79.2]、女童[OR=3；95%CI=1.2-8.7]、因 HIV 失去家庭成员的儿童[OR=3.5，95%CI=1.2-10]、照顾者认为儿童未受到污名化[OR=4，95%CI=1.6-11]以及负责抗逆转录病毒治疗的儿童[OR=16，95%CI=5-50]与 HIV 阳性状况披露显著相关。与接受抗逆转录病毒治疗<6 年的儿童相比，接受抗逆转录病毒治疗 10-15 年的儿童[OR=7；95%CI=2-27]更有可能知晓自己的 HIV 阳性状况。
HIV 感染者的 HIV 阳性状况披露比例较低。与 HIV 阳性状况披露相关的因素包括儿童的年龄、性别、父母的存在、污名、抗逆转录病毒治疗持续时间以及儿童对其药物的责任。HIV 护理提供者在支持披露时应考虑这些因素。
