The prevalence of disclosure of HIV status to HIV-infected children in Western Kenya

Matthew L. Turissini, Winstone M. Nyandiko, Samuel O. Ayaya, Irene Marete, Ann Mwangi, Victor Chemboi, Lucy Warui, Rachel C. Vreeman

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background: As antiretroviral therapy (ART) allows the world's 2.3 million human immunodeficiency virus (HIV)-infected children to grow and thrive, these children need to be informed of their HIV status. Neither the prevalence of disclosure to children nor its impact has been evaluated in most resourcelimited settings. Methods: We conducted a prospective assessment of a random sample of HIV-infected children ages 6-14 years enrolled in HIV care at a large referral clinic in Eldoret, Kenya. Clinicians administered questionnaires to children and caregivers independently at routine clinic visits to assess disclosure status, ART adherence, stigma, and depression. Children's demographic and clinical characteristics were extracted from chart review. We calculated descriptive statistics and performed logistic regression to assess the association between disclosure and other characteristics. Results: Two hundred seventy children-caregiver dyads completed questionnaires. The mean child age was 9.3 years (standard deviation 2.6); 49% were male, and 42% were orphans. 11.1% of children had been informed of their HIV status (N = 30). Of those under 10 years, 3.3% knew their status, whereas 9.2% of 10- to 12-year-olds and 39.5% of 13- to 14-year-olds knew they had HIV. Only age was significantly associated with disclosure status in both bivariate analyses (P < .0001) and multiple logistic regression (odds ratio 1.67, 95% confidence interval 1.36-2.05) when considering social demographics, disease stage variables, adherence, stigma measures, and depression. Conclusions: Rates of informing children in western Kenya of their HIV status are low, even among older children. Guiding families through developmentally appropriate disclosure processes should be a key facet of long-term pediatric HIV management.

Original languageEnglish (US)
Article numberpit024
Pages (from-to)136-143
Number of pages8
JournalJournal of the Pediatric Infectious Diseases Society
Volume2
Issue number2
DOIs
StatePublished - Jun 2013

Keywords

  • Africa
  • Disclosure
  • HIV
  • Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases

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    Turissini, M. L., Nyandiko, W. M., Ayaya, S. O., Marete, I., Mwangi, A., Chemboi, V., Warui, L., & Vreeman, R. C. (2013). The prevalence of disclosure of HIV status to HIV-infected children in Western Kenya. Journal of the Pediatric Infectious Diseases Society, 2(2), 136-143. [pit024]. https://doi.org/10.1093/jpids/pit024