Caregiver and child factors predicting HIV status disclosure among children enrolled on ART: a cross-regional study in Addis Ababa and Oromia, Ethiopia.

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.