Models of support for disclosure of HIV status to HIV-infected children and adolescents in resource-limited settings

the IeDEA Pediatric Working Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Disclosure of HIV status to HIV-infected children and adolescents is a major care challenge. We describe current site characteristics related to disclosure of HIV status in resource-limited paediatric HIV care settings within the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods: An online site assessment survey was conducted across the paediatric HIV care sites within six global regions of IeDEA. A standardized questionnaire was administered to the sites through the REDCap platform. Results: From June 2014 to March 2015, all 180 sites of the IeDEA consortium in 31 countries completed the online survey: 57% were urban, 43% were health centres and 86% were integrated clinics (serving both adults and children). Almost all the sites (98%) reported offering disclosure counselling services. Disclosure counselling was most often provided by counsellors (87% of sites), but also by nurses (77%), physicians (74%), social workers (68%), or other clinicians (65%). It was offered to both caregivers and children in 92% of 177 sites with disclosure counselling. Disclosure resources and procedures varied across geographical regions. Most sites in each region reported performing staff members' training on disclosure (72% to 96% of sites per region), routinely collecting HIV disclosure status (50% to 91%) and involving caregivers in the disclosure process (71% to 100%). A disclosure protocol was available in 14% to 71% of sites. Among the 143 sites (79%) routinely collecting disclosure status process, the main collection method was by asking the caregiver or child (85%) about the child's knowledge of his/her HIV status. Frequency of disclosure status assessment was every three months in 63% of the sites, and 71% stored disclosure status data electronically. Conclusion: The majority of the sites reported offering disclosure counselling services, but educational and social support resources and capacities for data collection varied across regions. Paediatric HIV care sites worldwide still need specific staff members' training on disclosure, development and implementation of guidelines for HIV disclosure, and standardized data collection on this key issue to ensure the long-term health and wellbeing of HIV-infected youth.

Original languageEnglish (US)
Article numbere25157
JournalJournal of the International AIDS Society
Volume21
Issue number7
DOIs
StatePublished - Jul 1 2018

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Disclosure
HIV
Counseling
Caregivers
Acquired Immunodeficiency Syndrome
Epidemiology
Databases
Pediatrics
Health
Social Support

Keywords

  • adolescents
  • counselling
  • disclosure
  • low- and middle-income countries
  • site assessment
  • vertical HIV infection

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Models of support for disclosure of HIV status to HIV-infected children and adolescents in resource-limited settings. / the IeDEA Pediatric Working Group.

In: Journal of the International AIDS Society, Vol. 21, No. 7, e25157, 01.07.2018.

Research output: Contribution to journalArticle

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title = "Models of support for disclosure of HIV status to HIV-infected children and adolescents in resource-limited settings",
abstract = "Introduction: Disclosure of HIV status to HIV-infected children and adolescents is a major care challenge. We describe current site characteristics related to disclosure of HIV status in resource-limited paediatric HIV care settings within the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods: An online site assessment survey was conducted across the paediatric HIV care sites within six global regions of IeDEA. A standardized questionnaire was administered to the sites through the REDCap platform. Results: From June 2014 to March 2015, all 180 sites of the IeDEA consortium in 31 countries completed the online survey: 57{\%} were urban, 43{\%} were health centres and 86{\%} were integrated clinics (serving both adults and children). Almost all the sites (98{\%}) reported offering disclosure counselling services. Disclosure counselling was most often provided by counsellors (87{\%} of sites), but also by nurses (77{\%}), physicians (74{\%}), social workers (68{\%}), or other clinicians (65{\%}). It was offered to both caregivers and children in 92{\%} of 177 sites with disclosure counselling. Disclosure resources and procedures varied across geographical regions. Most sites in each region reported performing staff members' training on disclosure (72{\%} to 96{\%} of sites per region), routinely collecting HIV disclosure status (50{\%} to 91{\%}) and involving caregivers in the disclosure process (71{\%} to 100{\%}). A disclosure protocol was available in 14{\%} to 71{\%} of sites. Among the 143 sites (79{\%}) routinely collecting disclosure status process, the main collection method was by asking the caregiver or child (85{\%}) about the child's knowledge of his/her HIV status. Frequency of disclosure status assessment was every three months in 63{\%} of the sites, and 71{\%} stored disclosure status data electronically. Conclusion: The majority of the sites reported offering disclosure counselling services, but educational and social support resources and capacities for data collection varied across regions. Paediatric HIV care sites worldwide still need specific staff members' training on disclosure, development and implementation of guidelines for HIV disclosure, and standardized data collection on this key issue to ensure the long-term health and wellbeing of HIV-infected youth.",
keywords = "adolescents, counselling, disclosure, low- and middle-income countries, site assessment, vertical HIV infection",
author = "{the IeDEA Pediatric Working Group} and Elise Arriv{\'e} and Samuel Ayaya and Davies, {Mary Ann} and Cleophas Chimbetete and Andrew Edmonds and Patricia Lelo and Fong, {Siew Moy} and Razali, {Kamarul Azahar} and Kouadio Kouakou and Duda, {Stephany N.} and Val{\'e}riane Leroy and Rachel Vreeman",
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AU - Arrivé, Elise

AU - Ayaya, Samuel

AU - Davies, Mary Ann

AU - Chimbetete, Cleophas

AU - Edmonds, Andrew

AU - Lelo, Patricia

AU - Fong, Siew Moy

AU - Razali, Kamarul Azahar

AU - Kouakou, Kouadio

AU - Duda, Stephany N.

AU - Leroy, Valériane

AU - Vreeman, Rachel

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N2 - Introduction: Disclosure of HIV status to HIV-infected children and adolescents is a major care challenge. We describe current site characteristics related to disclosure of HIV status in resource-limited paediatric HIV care settings within the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods: An online site assessment survey was conducted across the paediatric HIV care sites within six global regions of IeDEA. A standardized questionnaire was administered to the sites through the REDCap platform. Results: From June 2014 to March 2015, all 180 sites of the IeDEA consortium in 31 countries completed the online survey: 57% were urban, 43% were health centres and 86% were integrated clinics (serving both adults and children). Almost all the sites (98%) reported offering disclosure counselling services. Disclosure counselling was most often provided by counsellors (87% of sites), but also by nurses (77%), physicians (74%), social workers (68%), or other clinicians (65%). It was offered to both caregivers and children in 92% of 177 sites with disclosure counselling. Disclosure resources and procedures varied across geographical regions. Most sites in each region reported performing staff members' training on disclosure (72% to 96% of sites per region), routinely collecting HIV disclosure status (50% to 91%) and involving caregivers in the disclosure process (71% to 100%). A disclosure protocol was available in 14% to 71% of sites. Among the 143 sites (79%) routinely collecting disclosure status process, the main collection method was by asking the caregiver or child (85%) about the child's knowledge of his/her HIV status. Frequency of disclosure status assessment was every three months in 63% of the sites, and 71% stored disclosure status data electronically. Conclusion: The majority of the sites reported offering disclosure counselling services, but educational and social support resources and capacities for data collection varied across regions. Paediatric HIV care sites worldwide still need specific staff members' training on disclosure, development and implementation of guidelines for HIV disclosure, and standardized data collection on this key issue to ensure the long-term health and wellbeing of HIV-infected youth.

AB - Introduction: Disclosure of HIV status to HIV-infected children and adolescents is a major care challenge. We describe current site characteristics related to disclosure of HIV status in resource-limited paediatric HIV care settings within the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods: An online site assessment survey was conducted across the paediatric HIV care sites within six global regions of IeDEA. A standardized questionnaire was administered to the sites through the REDCap platform. Results: From June 2014 to March 2015, all 180 sites of the IeDEA consortium in 31 countries completed the online survey: 57% were urban, 43% were health centres and 86% were integrated clinics (serving both adults and children). Almost all the sites (98%) reported offering disclosure counselling services. Disclosure counselling was most often provided by counsellors (87% of sites), but also by nurses (77%), physicians (74%), social workers (68%), or other clinicians (65%). It was offered to both caregivers and children in 92% of 177 sites with disclosure counselling. Disclosure resources and procedures varied across geographical regions. Most sites in each region reported performing staff members' training on disclosure (72% to 96% of sites per region), routinely collecting HIV disclosure status (50% to 91%) and involving caregivers in the disclosure process (71% to 100%). A disclosure protocol was available in 14% to 71% of sites. Among the 143 sites (79%) routinely collecting disclosure status process, the main collection method was by asking the caregiver or child (85%) about the child's knowledge of his/her HIV status. Frequency of disclosure status assessment was every three months in 63% of the sites, and 71% stored disclosure status data electronically. Conclusion: The majority of the sites reported offering disclosure counselling services, but educational and social support resources and capacities for data collection varied across regions. Paediatric HIV care sites worldwide still need specific staff members' training on disclosure, development and implementation of guidelines for HIV disclosure, and standardized data collection on this key issue to ensure the long-term health and wellbeing of HIV-infected youth.

KW - adolescents

KW - counselling

KW - disclosure

KW - low- and middle-income countries

KW - site assessment

KW - vertical HIV infection

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