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Munyayi FK, van Wyk BE. Determinants and rates of retention in HIV care among adolescents receiving antiretroviral therapy in Windhoek, Namibia: a baseline cohort analysis. BMC Public Health 2023; 23:458. [PMID: 36890540 PMCID: PMC9994767 DOI: 10.1186/s12889-023-15356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/01/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Long-term engagement in HIV care is essential to achieving and maintaining viral suppression. Adolescents living with HIV (ALHIV) experience many barriers to remaining engaged in care and treatment programs. Higher attrition among adolescents compared to adults remains a huge concern due to unique psychosocial and health systems challenges adolescents face, and recently the COVID-19 pandemic effects. We report on determinants and rates of retention in care in adolescents aged 10-19 years enrolled on antiretroviral therapy (ART) in Windhoek, Namibia. METHODS A retrospective cohort analysis of routine clinical data of 695 adolescents aged 10-19 years enrolled for ART at 13 Windhoek district public healthcare facilities, between January 2019 and December 2021 was conducted. Anonymized patient data were extracted from an electronic database and registers. Bivariate and Cox proportional hazards analysis were performed to determine factors associated with retention in care among ALHIV at 6, 12, 18, 24 and 36 months. Retention in care trends were also described using the Kaplan-Meier survival analysis. RESULTS The retention in care rates at 6, 12, 18, 24 and 36 months were 97.7%, 94.1%, 92.4%, 90.2%, and 84.6%, respectively. Our study population had predominantly treatment-experienced adolescents, who initiated ART between birth and 9 years (73.5%), were on treatment for > 24 months (85.0%), and on first-line ART (93.1%). After controlling for confounders, the risk of dropping out of care was increased for older adolescents aged 15-19 years (aHR = 1.964, 95% CI 1.033-3.735); adolescents on switched ART regimens (Second line + Third line regimen) (aHR = 4.024, 95% CI 2.021-8.012); adolescents who initiated ART at 15-19 years (aHR = 2.179, 95%CI 1.100-4.316); and male adolescents receiving ART at a PHC clinic (aHR = 4.322, 1.332-14.024). Conversely, the risk of ALHIV dropping out of care decreased for adolescents whose TB screen results were negative (aHR = 0.215, 95% CI 0.095-0.489). CONCLUSION Retention in care rates among ALHIV in Windhoek do not meet the UNAIDS revised target of 95%. Gender-specific interventions are needed to keep male and older adolescents motivated and engaged in long-term care, and to promote adherence amongst those adolescents who were initiated on ART in late adolescence (15-19 years).
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Affiliation(s)
- Farai K Munyayi
- School of Public Health, University of the Western Cape, Cape Town, South Africa.
| | - Brian E van Wyk
- School of Public Health, University of the Western Cape, Cape Town, South Africa
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Adella GA, Yimer MA, Abebe EC. Human immunodeficiency virus positive status disclosure among children in northwest Ethiopia: a cross-sectional study. Afr Health Sci 2023; 23:178-189. [PMID: 37545911 PMCID: PMC10398430 DOI: 10.4314/ahs.v23i1.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background Human Immunodeficiency Virus positive status disclosure is an essential component of pediatric care and longterm disease management. However, one of the greatest challenges that caregiver/mothers and health care workers face is the disclosure of HIV positive status to children living with the virus. Therefore, the objective of this study was to assess HIV positive status disclosure and associated factors among HIV positive children in northwest Ethiopia. Methods Institutional based cross-sectional study was conducted among 417 sampled HIV positive children attending pediatric ART clinics of public health facilities from February 01 to March 30 2020 in northwest Ethiopia. Simple random sampling technique was used to select study participants. A structured interviewer administered questionnaire was used for data collection and the collected data entered into Epi data software. Binary logistic regression analysis was done and variables with P-value <0.05 was considered as a significant predictors of HIV positive status disclosure of HIV positive children. Result From 417 sampled population, 390 were involved in this study making 93.5% response rate. The study revealed that 53.6% with 95% CI (0.486-0.586) of HIV positive children knew their HIV positive sero status. Caregiver/mothers who had greater than three family sizes (AOR=1.984, 95% CI=1.046-3.762), children whose ages greater than 10 years (AOR=6.679, 95% CI=3.372-13.227) and children on ART for more than 5 years (AOR=8.96, 95% CI=6.402-12.257) were predictors of HIV positive status disclosure. Conclusion The HIV positive status disclosure was high in the study area relative to other studies. Family size, children age, and length of children on ART were predictors of HIV positive status disclosure for HIV positive children. Health care providers, especially those working at pediatrics ART clinics should keep these factors in mid while working with caregivers to encourage disclosure of HIV positive status.
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Affiliation(s)
- Getachew Asmare Adella
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia, Ethiopia
| | - Meklit Abie Yimer
- College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Reproductive Health and Nutrition Department, School of Public Health College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Qur'aniati N, Sweet L, De Bellis A, Hutton A. 'Diagnosis, disclosure and stigma: The perspectives of Indonesian children with HIV and their families'. J Child Health Care 2022:13674935221136229. [PMID: 36315215 DOI: 10.1177/13674935221136229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This grounded theory study aimed to explore the subjective experiences of children living with Human Immunodeficiency Virus (HIV) from the perspective of children and their families in Indonesia. Twenty participants were interviewed, consisting of 12 children aged 9-18 years and eight family members. Using grounded theory analysis, this study identified three categories: 'coping with diagnosis', 'disclosing their status' and 'living with the stigma of HIV'. Participants responded with shock, denial, sadness, secrecy and often had misconceptions about the virus to the diagnosis of themselves or their children. After diagnosis, children with HIV and their families continuously lived with stigma stemming from individual and societal beliefs about the virus. This stigma manifested in actions such as isolation, disclosure avoidance, secrecy, deception and social rejection. Because of these stigmatisations, many of the participants decided not to disclose the child's HIV status and used status strategies such as telling lies, keeping secrets and keeping their distance. The participants offered insight into the need for comprehensive programs to address care gaps. This study highlights that health professionals need to develop practical guidelines to support families during the disclosure process, provide psychosocial care for children, and create stigma reduction interventions for children with HIV.
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Affiliation(s)
- Nuzul Qur'aniati
- Faculty of Nursing, 356774Universitas Airlangga, Surabaya, Indonesia
| | - Linda Sweet
- School of Nursing and Midwifery, 110580Deakin University, Burwood, VIC, Australia
- Centre for Quality and Patient Safety Research, Western Health Partnership, St Albans, VIC, Australia
| | - Anita De Bellis
- College of Nursing and Health Sciences, 1065Flinders University, Adelaide, SA, Australia
| | - Alison Hutton
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, 5982The University of Newcastle, Callaghan, NSW, Australia
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Chanie MG, Abebe A, Muche A, Worku N. HIV Positivity Disclosure Among Children Living with HIV/AIDS and Currently on HAART in Dessie, Northeast Ethiopia. HIV AIDS (Auckl) 2022; 14:461-472. [PMID: 36237554 PMCID: PMC9553231 DOI: 10.2147/hiv.s356507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/18/2022] [Indexed: 11/07/2022] Open
Abstract
Background Disclosure of HIV/AIDS positive test result to children is a continuing routine problem in the health care setting. Some of the families as well as the health care workers are negligent to inform children of their HIV status. This study was aimed at identifying the prevalence of HIV-positivity disclosure and the factors among 6–15-year-old children currently on HAART in Dessie, Ethiopia. Methods A facility based cross-sectional study design was performed in Dessie from January 21 to March 12, 2020 among 346 parents/caregivers with children living with HIV and currently on HAART. The data were collected using pre-tested, structured and self-administered questionnaires. The collected data were entered into Epi info v.7.1 and exported into SPSS version 23 for further analysis. Binary and multivariable logistic regression was employed and statistically significant factors were identified at 95% CI and at p-value <0.05. Results HIV positivity disclosure was found to be 29.2% (26.3–34.7%). Being widowed mothers/caregivers, 11–15-year-old children, child received support from NGOs and having a mother with a negative HIV test were found to be statistically significant factors for disclosure. Conclusion The overall HIV positivity disclosure to children living with HIV was found to be low in contrast to the WHO standard. In other ways, it was comparable with the Ethiopian figures. Health workers and managers need to focus on strengthening child support, make known the maternal/caregivers’ HIV status, and child age specific effective interventions to improve disclosure of HIV positivity status for children living with HIV for better ART adherence and treatment outcomes.
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Affiliation(s)
- Muluken Genetu Chanie
- Department of Health Systems and Policy, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abenezer Abebe
- Department of Pediatrics, Dessie Specialized Hospital, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nigusu Worku
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Nigusu Worku, Email
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Belay GM, Yehualashet FA, Ewunetie AW, Atalell KA. Pediatrics HIV-positive status disclosure and its predictors in Ethiopia: a systematic review and meta-analysis. PeerJ 2022; 10:e13896. [PMID: 36032949 PMCID: PMC9415365 DOI: 10.7717/peerj.13896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/22/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction HIV-positive status disclosure for children is challenging for family members, guardians, and healthcare professionals. Disclosure is very challenging, particularly for children, yet no systematic synthesis of evidence accurately measures HIV-positive status disclosure in children. This systematic review and meta-analysis study aimed to quantify the national prevalence of pediatric HIV-positive status disclosure in Ethiopia and identify factors associated with HIV-positive status disclosure. Method We systematically searched PubMed, EMBASE, Web of Science databases, and google scholar for relevant published studies. Studies published in the English language and conducted with cohort, case-control, and cross-sectional designs were eligible for the review. The primary and secondary outcomes of the study were HIV-positive status disclosure and factors associated with HIV-positive status disclosure, respectively. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. A random effect- model was used to estimate the pooled prevalence of HIV-positive status disclosure. Heterogeneity and publication bias of included studies was determined using I2 and Egger's test, respectively. Result From 601 records screened, nine relevant studies consisting of 2,442 HIV-positive children were included in the analysis. The overall pooled prevalence of HIV-positive status disclosure among children living with HIV/AIDS in Ethiopia was 31.2% (95% CI [23.9-38.5]). HIV-negative status of caregivers (AOR: 2.01; 95% CI [1.28-3.18]), long duration on ART (greater than 5 years) (AOR: 3.2; 95% CI [1.77-5.78]) and older age of the child (>10 years) (AOR: 7.2; 95% CI [4.37-11.88]) were significantly associated with HIV-positive status disclosure. Conclusion Low prevalence of pediatric HIV-positive status disclosure was observed in Ethiopia. The longer duration of ART, the HIV-negative status of the caregiver, and older age greater than 10 years were the predictors of pediatric HIV-positive status disclosure. Health system leaders and policymakers shall design training and counseling programs for healthcare professionals and caregivers to enhance their awareness about HIV-positive status disclosure. Trial registration This review was registered under PROSPERO and received a unique registration number, CRD42019119049.
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Affiliation(s)
- Getaneh Mulualem Belay
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Fikadu Ambaw Yehualashet
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Amare Wondim Ewunetie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Kendalem Asmare Atalell
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Armoon B, Fleury MJ, Higgs P, Bayat AH, Bayani A, Mohammadi R, Ahounbar E. Prevalence, socio-demographics and service use determinants associated with disclosure of HIV/AIDS status to infected children: a systematic review and meta-analysis by 1985-2021. Arch Public Health 2022; 80:154. [PMID: 35681146 PMCID: PMC9178876 DOI: 10.1186/s13690-022-00910-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/03/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) is a public health issue of global importance. To our knowledge, no previous meta-analysis documenting the prevalence, socio-demographic, and service use determinants associated with HIV/AIDS disclosure to infected children has been conducted. The present study aimed to determine the prevalence, socio-demographics and service use determinants associated with the disclosure of HIV/AIDS status to infected children. METHODS Studies in English published between 01 January 1985 and 01 November 2021, and available on PubMed, Scopus, Web of Science, and Cochrane electronic databases were searched. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR), and 95% confidence intervals. RESULTS After article duplicates were excluded, assessments of abstracts were completed, and full-text papers evaluated, 37 studies were included in this meta-analysis. The prevalence of the disclosure of HIV status to children was measured to be 41% in this research. The odds that a child of 10 years and older is informed that they are HIV-positive is 3.01 time the odds that younger children are informed. Those children who had primary or lower schooling level were 2.41 times more likely to be informed of their HIV-positive status than children with higher levels of schooling. Children who had a non-biological parents were 3.17 times more likely to have been disclose being HIV-positive; social support (OR = 8.29, 95%CI = 2.34, 29.42), children who had higher levels of social supports were 8.29 times more likely to disclose HIV-positive; the primary educational level of caregivers (OR = 2.03, 95%CI = 1.43, 2.89), respondents who had caregivers with primary education level were 2.03 times more likely to disclose HIV-positive; antiretroviral treatment (ART) adherence (OR = 2.59, 95%CI = 1.96, 3.42), participants who adhered to ART were 2.59 times more likely to disclose HIV-positive and hospital follow-up (OR = 2.82, 95%CI = 1.85, 4.29), those who had hospital follow-up were 2.82 times more likely to disclose HIV-positive; were all significantly associated with the disclosure of HIV/AIDS status to infected children. CONCLUSION Such data are of importance for healthcare pediatrics HIV care professionals. Facilitating HIV diagnosis and disclosure to the infected children and ensuring access to HIV treatment will likely prevent secondary HIV transmission. Healthcare professionals are expected to provide age-appropriate counseling services to this population.
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Affiliation(s)
- Bahram Armoon
- Douglas Mental Health University Institute, Research Centre, 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Research Centre, 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Peter Higgs
- Department of Public Health, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, VIC, Australia
| | - Amir-Hossien Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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Walle BG, Tiruneh CM, Dessie T, Selomon N, Kassaw A, Chekole B, Wubneh M, Lankrew T, Bayih WA. Factors associated with children's HIV- positive status disclosure in Wolaita Zone, Southern Ethiopia: a cross-sectional study. Ital J Pediatr 2022; 48:86. [PMID: 35668505 PMCID: PMC9169329 DOI: 10.1186/s13052-022-01287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Children’s HIV-positive status disclosure is an essential component of chronic care & long-term disease management. The modalities of status disclosure are complex and vary across different communities. Although data from various settings are necessary to overcome this problem, evidence is limited, specifically in the in the study areas. Therefore, this study aimed to assess the prevalence of HIV-positive status disclosure and associated factors among children on antiretroviral therapy (ART). Methods A mixed-method, facility-based study was conducted: among 203 caregivers with children in Wolaita Zone, Southern Ethiopia. We used in-depth interviews for qualitative data in addition to structured questionnaires. Simple random sampling for quantitative and purposive sampling for qualitative parts was applied. We used Content or Thematic analysis for qualitative and Binary logistic regression for quantitative. Results All the caregivers were interviewed and majorities (84.7%) of them were female. One hundred twelve children (55.2%) were below 12 years of age. In this study, the overall prevalence of children with HIV-positive status disclosure was 46.8%. Being 12 or more years of age (AOR = 7.5, 95% CI: 2.9–15.6), duration on ART 72 or more months (AOR = 3.8, 95% CI: 1.7–6.7), death of the parent (AOR = 2.0, 95% CI: 1.1- 3.8), and having follow up in the hospital (AOR = 2.1, 95% CI: 1.3–4.7) were associated with disclosure. Being an immature child was the commonest reason cited by caregivers for non-disclosure. Frequent questions by the child about why they are taking drugs, for better self-care, and treatment adherence were the commonest reason of caregivers for disclosing their children’s HIV-positive status. Conclusion In our study, children’s HIV-positive status disclosure was significantly low. This study identified different factors (Health facility, children, and caregivers-related factors) as the main reason for disclosing children’s HIV-positive status. Hence, health care workers should give special attention to children’s HIV-positive status disclosure, which helps to increase the effectiveness of treatment and prevent further HIV transmission. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01287-6.
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Affiliation(s)
- Belete Gelaw Walle
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, P.O.Box 138, Wolaita Sodo, Ethiopia.
| | - Chalie Marew Tiruneh
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Dessie
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Nigusie Selomon
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Kassaw
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bogale Chekole
- Department of Nursing, College of Medicine & Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Moges Wubneh
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tadele Lankrew
- Department of Adult Health Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Maternal and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Lemma T, Silesh M, Taye BT, Desta K, Kitaw TM, Tekalign T. HIV Serostatus Disclosure and Its Predictors Among Children Living With HIV in Ethiopia: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:859469. [PMID: 35719618 PMCID: PMC9201957 DOI: 10.3389/fpubh.2022.859469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022] Open
Abstract
Background HIV disclosure among children refers to when the caregiver is having disclosed to the child that he or she has HIV specifically. Disclosure significantly improved adherence to treatment and quality of life among children living with HIV/AIDS. Even though, the benefits of disclosure are considerable, informing a child of his or her own HIV status is often delayed. There is a dearth of studies on HIV serostatus disclosure among children in Ethiopia. Therefore, this study aimed to assess the pooled prevalence of HIV serostatus disclosure and associated factors among children living with HIV in Ethiopia. Methods and Materials Using a combination of search terms and Boolean operators, studies were retrieved from Pub Med/MEDLINE, EMBASE, CINAHL, Science Direct, Scopus, Web of Science, Cochran library, and Google Scholar. Five authors independently assessed the quality of each study using the modified Newcastle Ottawa Scale (NOS) for cross-sectional studies. STATA Version 11 software was used for statistical analyses. The random-effects (Der Simonian and Laird) method was used for the meta-analysis. The heterogeneity test was carried out with the help of I-squared (I2) statistics. A leave-one-out sensitivity analysis was carried out. Results A total of 12 articles with 3,410 participants were included in this systematic review and meta-analysis. The pooled prevalence of HIV serostatus disclosure among children was 36.87% (95% CI: 29.30, 44.44; I2 = 95.8%). Children aged older than 10 years (p = 0.003) and caregivers with primary and above education (p < 0.001) were factors significantly associated with HIV serostatus disclosure among children. Conclusions The finding of this study showed that HIV serostatus disclosure among children is relatively low. Therefore, developing clear guideline on HIV serostatus disclosure among children, strengthening public health education or community awareness creation about HIV/AIDS to promote the benefits of disclosure and extensively provision of counseling by health care providers are essential to enhance HIV serostatus disclosure among children. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021239035.
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Affiliation(s)
- Tesfanesh Lemma
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mulualem Silesh
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kelem Desta
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tebabere Moltot Kitaw
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tiwabwork Tekalign
- School of Nursing, Arba Minch University College of Medicine and Health Science, Arba Minch, Ethiopia
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Yami DB, Tuji TS, Gelete BW, Beyene Workie K. Disclosure status of HIV-positive children and associated factors among children in public health facilities in East Arsi zone, Oromia regional state, South Eastern Ethiopia: A cross-sectional study. SAGE Open Med 2022; 10:20503121211068725. [PMID: 35024145 PMCID: PMC8744189 DOI: 10.1177/20503121211068725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/05/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: This study aims to assess the disclosure status of HIV-positive children and
its associated factors in selected hospitals in East Arsi zone, Oromia
regional state, Ethiopia, 2020. Methods: Institutional-based cross-sectional study design was conducted on 410 sample
size. Four hospitals were randomly selected among hospitals that currently
gave service. Data were collected from caregivers/biological parents by
interviewing from 30 July 2020 to 30 August 2020 using the systematic random
sampling technique. In logistic regression analysis, the variables which had
independent correlations with dependent variable were identified based on
adjusted odds ratio and a p value <0.05 with 95%
confidence interval was claimed as statistically significant. Results: Disclosure status of HIV-positive children was 59.8%, 95% confidence interval
(54.9, 64.1). Children diagnosed at the age of <5 (adjusted odds ratio =
0.25, 95% confidence interval (0.126, 0.49)), antiretroviral therapy
follow-up for 6–15 years (adjusted odds ratio = 2.08, 95% confidence
interval (1.013, 4.29)), children diagnosed at the appropriate age of ⩾12
years (adjusted odds ratio = 1.95, 95% confidence interval (1.09, 3.49)),
and children diagnosed at the age of <11 years (adjusted odds ratio =
4.5, 95% confidence interval (3.45, 8.38)) were positively associated
factors to disclose status. Conclusion: The disclosure status of HIV-positive children was low in this study.
Antiretroviral therapy follow-up for 6–15 years, children diagnosed at the
appropriate age of ⩾12 years, children diagnosed at the age of <5 years,
and children who aged below 11 years were positively associated with
disclosure status. Thus, we recommended, health care providers and all
stakeholders should give age-appropriate counseling regarding when and why
to disclose their status.
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Affiliation(s)
- Dereje Bikila Yami
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Techane Sisay Tuji
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
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Cremonese L, de Mello Padoin SM, de Paula CC. Communication of HIV diagnosis in proper time: scoping review. Rev Esc Enferm USP 2021; 55:e20210153. [PMID: 34730609 DOI: 10.1590/1980-220x-reeusp-2021-0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To map how the communication of the HIV infection diagnosis occurs in pediatrics. METHODS Scoping review of the 64 original articles. We selected research papers in Portuguese, English, or Spanish, with the participants: child, adolescent, relative/family, and/or health professional from 2011-2020. We accessed the following sources: PubMed, CINAHL, Scopus, WoS, ASSIA, PsycINFO, ERIC, Sociological Abstracts, Edubase, LILACS, BDENF, and IndexPsi. RESULTS Regarding the population, it was evident to us that the relative must be the sender of the diagnosis with the professionals' support; regarding the reasons for the communication, the child maturity, expressed by questions, the necessity of therapy adherence, abilities to communicate and the right of knowing the diagnosis must be considered. The communication channel is centered on materials that promote comprehension, quantity, and quality of information. That indicated an interactive process. Regarding the effects, they are beneficial when the communication occurs at a proper time. CONCLUSION Communication must occur through a process that includes professional support to the relatives/family, development of abilities to evaluate the appropriate moment, and the monitoring effect.
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Affiliation(s)
- Luiza Cremonese
- Universidade Luterana do Brasil, Cachoeira do Sul, RS, Brazil
| | | | - Cristiane Cardoso de Paula
- Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.,Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI. (JBI Brazil) São Paulo, SP, Brazil
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Tucho WA, Tekelehaimanot AN, Habte MB. Disclosure Status and Associated Factors Among Children on Antiretroviral Therapy in Ethiopia. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:299-306. [PMID: 34211313 PMCID: PMC8242142 DOI: 10.2147/phmt.s314259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022]
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 p-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.
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Affiliation(s)
- Walelign Atomsa Tucho
- Department of Disease Prevention and Control, Bench Sheko Zone Health Office, Mizan-Aman, Southwest Ethiopia
| | | | - Mahilet Berhanu Habte
- Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Carlberg R, Wolgast E, Kristensson Hallström I, Biru M. Caregiver and child factors predicting HIV status disclosure among children enrolled on ART: a cross-regional study in Addis Ababa and Oromia, Ethiopia. AIDS Care 2021; 34:105-111. [PMID: 33938334 DOI: 10.1080/09540121.2021.1918622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION 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. METHODS Data from 231 children were collected prospectively through a structured questionnaire after initiation of ART treatment. Data were analysed with χ2 test for comparison and logistic regression to verify the prediction of independent variables with the child's HIV status disclosure. RESULTS 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.
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Affiliation(s)
- Rebecka Carlberg
- Child and Family Health, Medical Faculty, Department of Health Sciences, Lund University, Lund, Sweden
| | - Eva Wolgast
- Child and Family Health, Medical Faculty, Department of Health Sciences, Lund University, Lund, Sweden
| | | | - Mulatu Biru
- Child and Family Health, Medical Faculty, Department of Health Sciences, Lund University, Lund, Sweden
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Gelaw B, Mulatu G, Tesfa G, Marew C, Chekole B, Alebel A. Magnitude and associated factors of virological failure among children on ART in Bahir Dar Town public health facilities, Northwest Ethiopia: a facility based cross-sectional study. Ital J Pediatr 2021; 47:84. [PMID: 33823890 PMCID: PMC8025328 DOI: 10.1186/s13052-021-01030-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Despite the rapid scale-up of antiretroviral therapy, virologic failure has become global public health concern and challenge, especially in developing countries. Viral load monitoring is an important approach to identify treatment failure and develop public health interventions in children receiving antiretroviral therapy. Thus, this study aims to assess the magnitude and associated factors of virological failure among children on antiretroviral therapy. Methods A facility-based cross-sectional study was conducted among 399 HIV-positive children on antiretroviral therapy from 2016 to 2019 in Bahir Dar Town public health facilities. Data were extracted from children’s charts using a standardized data extraction tool, adapted from ART intake and follow-up forms. Data were entered using Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were done to identify factors associated with virological failure. Variables with p-values < 0.25 were fitted into the multivariable analysis. Finally, variables with p-values <0.05 were considered as statistically significant factors. Results The period prevalence of virological failure was found to be 14.8% (95% CI: 11.5–19.3%). Opportunistic infections (AOR = 2.19, CI: 1.13–4.25), history of treatment interruption and restart (AOR = 2.21, CI: 1.09–4.54), younger age (AOR = 2.42, CI: 1.02–5.74), poor/fair ART adherence (AOR = 2.19, CI: 1.05–4.57), and advanced baseline WHO clinical staging (AOR = 2.32, CI: 1.14–4.74) were found to be factors significantly associated with virological failure. Conclusion The magnitude of virological failure among HIV-infected children remained high. Children with poor/fair ART adherence, history of treatment interruption, advanced baseline WHO clinical staging, younger age, and opportunistic infections were significantly associated with virologic failure. Thus, special attention should be given to children who had poor/fair ART adherence and presenting with opportunistic infections.
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Affiliation(s)
- Belete Gelaw
- School of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia.
| | - Getasew Mulatu
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getasew Tesfa
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Chalie Marew
- College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bogale Chekole
- College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Animut Alebel
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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