Abstract
HIV-positive children in sub-Saharan Africa have numerous challenges to overcome. These challenges increase psychosocial stress as well as symptom burden including fatigue, weight loss, pain, and mental changes. The symptoms may persist even after initiation of antiretroviral therapy, so such children need additional care. Palliative care lays emphasis on holistic patient-centered care, including physical, psychological, social, and spiritual symptoms, alongside antiretroviral therapy. There is limited data on the impact of integrating palliative care with standard HIV care and treatment in children. The purpose of this study was to fill the gap in the literature by investigating the impact of palliative care on health status in HIV-positive children on antiretroviral therapy. The theoretical framework was based on the humanistic nursing theory. Using the Mann Whitney U and logistic regression tests, the health-related quality of life of 97 children who received palliative care in addition to standard HIV care was compared to 180 HIV-positive children who received standard HIV care only through chart reviews. According to study results, children receiving palliative care alongside antiretroviral therapy have better physical and psychosocial health compared to children receiving only antiretroviral therapy. Increasing age was a contributing factor to better psychosocial and physical health in patients receiving palliative care. Emotional, social, and school functioning are important factors that determine treatment outcomes in children on antiretroviral therapy, and addressing those factors through palliative care will create a positive social change by improving treatment outcomes, quality of life, and longevity.
Highlights
There are more than 33 million people infected with HIV worldwide [1]
The prevalence of anxiety and depression is higher among HIV-positive people than in the general population as well as populations with other chronic conditions such as renal failure or cancers [9]. While this compromises quality of life of individuals living with HIV/AIDS, it threatens the continued success of the roll out of antiretroviral therapy due to the association of depression and distress arising as a result of antiretroviral toxicity and poorer treatment outcomes [10]
The results of this study found that emotional functioning, school functioning, and social functioning were better in children who had received palliative care for at least 3 months compared to children who had received standard HIV care in Kenya
Summary
There are more than 33 million people infected with HIV worldwide [1]. Fifty percent of these are women, and 3.3 million are children [1]. The number of new HIV infections worldwide in a year is about 2.5 million in adults and 330,000 in children [1]. The prevalence of anxiety and depression is higher among HIV-positive people than in the general population as well as populations with other chronic conditions such as renal failure or cancers [9]. While this compromises quality of life of individuals living with HIV/AIDS, it threatens the continued success of the roll out of antiretroviral therapy due to the association of depression and distress arising as a result of antiretroviral toxicity and poorer treatment outcomes [10]
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