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埃塞俄比亚接受抗逆转录病毒治疗儿童的信息披露状况及相关因素

Disclosure Status and Associated Factors Among Children on Antiretroviral Therapy in Ethiopia.

作者信息

Tucho Walelign Atomsa, Tekelehaimanot Aderajew Nigusse, Habte Mahilet Berhanu

机构信息

Department of Disease Prevention and Control, Bench Sheko Zone Health Office, Mizan-Aman, Southwest Ethiopia.

Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

出版信息

Pediatric Health Med Ther. 2021 Jun 25;12:299-306. doi: 10.2147/PHMT.S314259. eCollection 2021.

Abstract

BACKGROUND

The World Health Organization recommends that children should be informed of their HIV status at age 6-12 years. However, disclosure of HIV status among children is very low in resource-limited areas, particularly in Ethiopia. So, the aim of this study was to determine the prevalence of disclosure and associated factors among a cohort of HIV-infected children in southwest Ethiopia.

METHODS

A facility-based cross-sectional study design was employed among caregivers of HIV-positive children aged 6-15 in Bench sheko and West Omo zone Southwest Ethiopia, from March 1 to April 20, 2020. Study participants were included using a consecutive sampling technique. Data were collected using a pretested interviewer administered questionnaire and checklist. A multivariable logistic regressions model was used to identify independent predictors of disclosure. The significance of association was declared by AOR at 95% confidence and a -value <0.05.

RESULTS

A total of 327 participants were involved in the study yielding a 95% response rate. The prevalence of HIV-positive status disclosure was 45.6% (95% CI=41.01-51.02). Caregiver secondary education and above (AOR=3.16, 95% CI=1.07-9.34), caregiver discussed about disclosure with health professionals (AOR= 9.56, 95% CI=4.88-18.74), child age 10-15 year old (AOR=3.64, 95% CI=1.64-8.08), duration on ART >5 years (AOR=5.08, 95% CI=1.57-16.37), treatment follow-up at hospital (AOR=2.23, 95% CI=1.27-5.01) and having treatment support for Children (AOR=3.84, 95% CI=1.88-7.85) were independent predictors of HIV-positive status disclosure.

CONCLUSION

Disclosure of HIV status to children is low. Caregivers educational status, caregivers discussion with health professional, older child, duration on ART of more than 5 year, getting treatment service from hospital, and having a treatment support group are factors that enable disclosure. Therefore, concerted efforts based on the findings of this study will be required to improve the disclosure status among HIV-positive children.

摘要

背景

世界卫生组织建议应在6至12岁时告知儿童其艾滋病毒感染状况。然而,在资源有限的地区,尤其是在埃塞俄比亚,向儿童披露艾滋病毒感染状况的比例非常低。因此,本研究的目的是确定埃塞俄比亚西南部一群艾滋病毒感染儿童中披露感染状况的患病率及相关因素。

方法

2020年3月1日至4月20日,在埃塞俄比亚西南部的本奇谢科和西奥莫地区,对6至15岁艾滋病毒阳性儿童的照顾者采用基于机构的横断面研究设计。采用连续抽样技术纳入研究参与者。使用预先测试的由访谈员管理的问卷和清单收集数据。使用多变量逻辑回归模型确定披露的独立预测因素。通过95%置信区间的调整比值比(AOR)和P值<0.05来宣布关联的显著性。

结果

共有327名参与者参与了研究,回复率为95%。艾滋病毒阳性状况披露的患病率为45.6%(95%置信区间=41.01 - 51.02)。照顾者接受过中等及以上教育(AOR = 3.16,95%置信区间=1.07 - 9.34)、照顾者与卫生专业人员讨论过披露事宜(AOR = 9.56,95%置信区间=4.88 - 18.74)、儿童年龄在10至15岁(AOR = 3.64,95%置信区间=1.64 - 8.08)、接受抗逆转录病毒治疗(ART)的时间>5年(AOR = 5.08,95%置信区间=1.57 - 16.37)、在医院接受治疗随访(AOR = 2.23,95%置信区间=1.27 - 5.01)以及有儿童治疗支持(AOR = 3.84,95%置信区间=1.88 - 7.85)是艾滋病毒阳性状况披露的独立预测因素。

结论

向儿童披露艾滋病毒感染状况的比例较低。照顾者的教育程度、照顾者与卫生专业人员的讨论、年龄较大的儿童、接受抗逆转录病毒治疗超过5年、从医院获得治疗服务以及有治疗支持小组是能够实现披露的因素。因此,需要根据本研究的结果共同努力,以改善艾滋病毒阳性儿童的披露状况。

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