Tari Kejela, Dheresa Merga, Abdisa Lemesa, Abebe Dawit, Admassu Desalegn, Mesfin Sinetibeb
School of Nursing and Midwifery, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Haro Maya, Ethiopia.
Int Health. 2025 Mar 4;17(2):214-220. doi: 10.1093/inthealth/ihae044.
In recent years, the life expectancy of human immunodeficiency virus (HIV)-infected children has increased with the availability of highly active antiretroviral therapy (ART). Regardless of the clinical recommendations encouraging HIV status disclosure, the practice of caregiver disclosure is frequently challenging due to many constraints associated with caregivers and healthcare personnel. As studies suggest, disclosure of the HIV-positive status of children is low, particularly in sub-Saharan Africa, where the majority of infected children reside. Thus the primary objective of this study was to evaluate the prevalence of HIV-positive status disclosure to infected children and the pertinent factors associated with caregivers of these children. Moreover, unlike previous studies conducted in Ethiopia, this study included children residing in orphanages.
We assessed HIV-positive status disclosure and associated factors among infected children in Hawassa, southern Ethiopia, from 25 May to 20 July 2021. A facility-based cross-sectional study was conducted in six public health facilities that provide HIV treatment and care. Data were collected from 355 randomly selected caregivers using interviewer-administered questionnaires and record reviews. Binary and multiple logistic regression was used to explore the association between independent variables and the outcome. The adjusted odds ratio (aOR) with 95% confidence interval (CI) was computed to determine the strength of the association and a p-value <0.05 was considered statistically significant.
Of the 355 children, 132 (37.2%) were informed about their HIV-positive status. Being of young age (≤12 y) (aOR 0.52 [95% CI 0.28 to 0.98]), having caregivers who were not familiar with anyone who disclosed children's HIV status (aOR 0.28 [95% CI 0.16 to 0.49]), children with a family that had a primary education (aOR 0.46 [95% CI 0.23 to 0.89]) and being a child who has taken ART for <5 y (aOR 0.47 [95% CI 0.28 to 0.80]) had a significant association with non-disclosure of HIV-positive status to infected children.
The findings show that disclosure of HIV-positive status to infected children is low. This suggests the need to provide support and education to caregivers, facilitate experience-sharing sessions between caregivers who disclosed the HIV status to infected children and implement age-specific disclosure interventions for young children. In addition, it is important to provide support and counselling to the children when their HIV status is disclosed.
近年来，随着高效抗逆转录病毒疗法（ART）的出现，感染人类免疫缺陷病毒（HIV）儿童的预期寿命有所增加。尽管有临床建议鼓励披露HIV感染状况，但由于与照顾者和医护人员相关的诸多限制，照顾者披露这一情况的做法常常具有挑战性。正如研究表明的那样，向儿童披露其HIV阳性状况的比例很低，尤其是在撒哈拉以南非洲地区，那里居住着大多数受感染儿童。因此，本研究的主要目的是评估向受感染儿童披露HIV阳性状况的比例以及与这些儿童照顾者相关的因素。此外，与之前在埃塞俄比亚进行的研究不同，本研究纳入了居住在孤儿院的儿童。
我们于2021年5月25日至7月20日评估了埃塞俄比亚南部哈瓦萨市受感染儿童的HIV阳性状况披露情况及相关因素。在六个提供HIV治疗和护理的公共卫生机构中开展了一项基于机构的横断面研究。使用访谈员管理的问卷和记录审查从355名随机选择的照顾者那里收集数据。采用二元和多元逻辑回归来探讨自变量与结果之间的关联。计算调整后的比值比（aOR）及95%置信区间（CI）以确定关联强度，p值<0.05被认为具有统计学意义。
在355名儿童中，132名（37.2%）被告知其HIV阳性状况。年龄较小（≤12岁）（aOR 0.52 [95% CI 0.28至0.98]）、照顾者不认识任何曾披露儿童HIV状况的人（aOR 0.28 [95% CI 0.16至0.49]）、家庭中主要成员接受过小学教育的儿童（aOR 0.46 [95% CI 0.23至0.89]）以及接受抗逆转录病毒治疗<5年的儿童（aOR 0.47 [95% CI 0.28至0.80]）与未向受感染儿童披露HIV阳性状况存在显著关联。
研究结果表明，向受感染儿童披露HIV阳性状况的比例很低。这表明需要为照顾者提供支持和教育，促进已向受感染儿童披露HIV状况的照顾者之间的经验分享，并针对幼儿实施特定年龄的披露干预措施。此外，在向儿童披露其HIV状况时，为他们提供支持和咨询也很重要。
