Child and Family Health, Medical Faculty, Department of Health Sciences, Lund University, Lund, Sweden.
AIDS Care. 2022 Jan;34(1):105-111. doi: 10.1080/09540121.2021.1918622. Epub 2021 May 3.
The World Health Organization recommends that for children of school age who are HIV-positive, their HIV status should be disclosed. The purpose of this study was to get a better understanding of disclosure rates among school-aged children in Ethiopia and to investigate the variables amongst caregivers and children predicting disclosure/non-disclosure.
Data from 231 children were collected prospectively through a structured questionnaire after initiation of ART treatment. Data were analysed with test for comparison and logistic regression to verify the prediction of independent variables with the child's HIV status disclosure.
Child age, caregiver marital status and caregiver residence were significantly associated with disclosure at 6 months. Similarly, child age, caregiver marital status and caregiver-child relationship were found to be significantly associated with disclosure at 12 months. Child age greater than nine years at 6 months (aOR 8.5, 95% CI: 2.5-29) and at 12 months (aOR 5.3, 95% CI: 1.8-16) were found to be significantly associated with disclosure. Furthermore, at 6 months, children with caregivers who had a partner they were not married to were more likely to disclose the HIV status to the child. This study suggests that paediatrics HIV care and treatment should consider these issues through contextualized strategies on child HIV disclosure and related challenges. Large-scale studies are required to better generalize on the subject.
世界卫生组织建议,对于感染艾滋病病毒的学龄儿童,应向其透露其艾滋病病毒感染状况。本研究旨在更好地了解埃塞俄比亚学龄儿童的披露率,并调查照顾者和儿童中预测披露/不披露的变量。
在开始接受抗逆转录病毒治疗后,通过结构化问卷前瞻性收集了 231 名儿童的数据。采用检验进行比较分析,采用逻辑回归验证独立变量与儿童 HIV 状态披露的预测关系。
儿童年龄、照顾者婚姻状况和照顾者居住地在 6 个月时与披露显著相关。同样,儿童年龄、照顾者婚姻状况和照顾者与儿童的关系在 12 个月时与披露显著相关。6 个月时年龄大于 9 岁的儿童(优势比 8.5,95%置信区间:2.5-29)和 12 个月时年龄大于 9 岁的儿童(优势比 5.3,95%置信区间:1.8-16)与披露显著相关。此外,6 个月时,与没有结婚伴侣的照顾者一起的儿童更有可能向儿童透露其 HIV 状况。本研究表明,儿科 HIV 护理和治疗应通过针对儿童 HIV 披露和相关挑战的情境化策略考虑这些问题。需要进行大规模研究,以便更好地推广这一主题。