Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Rachel Vreeman, Michael L. Scanlon, Irene Marete, Ann Mwangi, Thomas Inui, Carole I. McAteer, Winstone M. Nyandiko

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Knowledge of ones own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, childrens mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a childs knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes.

Original languageEnglish (US)
Pages (from-to)6-17
Number of pages12
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume27
DOIs
StatePublished - Nov 2 2015

Fingerprint

Kenya
Disclosure
HIV
adolescent
Caregivers
caregiver
Fear
quality of life
Quality of Life
Depression
anxiety
Disease
Medication Adherence
Africa South of the Sahara
Disease Management
WHO
dyad
trauma
Reference Values
medication

Keywords

  • adolescents
  • disclosure
  • HIV
  • mental health
  • resource-limited setting

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Social Psychology

Cite this

Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya. / Vreeman, Rachel; Scanlon, Michael L.; Marete, Irene; Mwangi, Ann; Inui, Thomas; McAteer, Carole I.; Nyandiko, Winstone M.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 27, 02.11.2015, p. 6-17.

Research output: Contribution to journalArticle

Vreeman, Rachel ; Scanlon, Michael L. ; Marete, Irene ; Mwangi, Ann ; Inui, Thomas ; McAteer, Carole I. ; Nyandiko, Winstone M. / Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya. In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2015 ; Vol. 27. pp. 6-17.
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