Challenges of Caregivers to Disclose their Children’s HIV Positive Status Receiving Highly Active Anti Retroviral Therapy at Pediatric AntiRetroviral Therapy Clinics in Bahir Dar, North West Ethiopia

Abstract

Background: HIV infected children who started highly active antiretroviral therapy in antiretroviral therapy clinics have survived to older age, and disclosure has become an essential part of their care. Hence, this study tried to (a) estimate the prevalence of HIV disclosure among school-aged children in Bahir Dar, North West Ethiopia, and (b) assess caregivers’ barriers to disclose their children’s HIV positive status receiving highly active antiretroviral therapy in pediatric antiretroviral therapy clinics. Methods: Institution based cross sectional study were conducted among 231 caregivers of pediatric antiretroviral therapy children on highly active antiretroviral therapy aged 6-14 years in four centres in Bahir Dar, North West Ethiopia. Caregivers were obtained proportionally and interviewed consecutively with convenience to respond for the structured pre-tested questionnaire. Data were entered into Epi Info version 3.5 and analyzed by using SPSS version 20 software for windows. Bivariate and multivariate logistic regression analyses were done. Results: The prevalence of disclosure of children’s HIV positive status on highly active antiretroviral therapy was 31.5%. Religion of caregivers (AOR = 4.27 [95% CI = 1.24, 14.73]), family number (AOR = 3.73 [95% CI = 1.11, 12.48]), age of child (AOR = 9.87 [95% CI = 3.47, 28.07]), child age when ART started (AOR = 6.15 [95% CI = 1.76, 21.50]), and children time on ART (AOR = 5.40 [95% CI = 1.87, 15.55]) were found to have statistically significant association with disclosure of HIV positive status to HIV infected children. Conclusion: Addressing and scaling up efforts on stigma and discrimination in neighbourhood, communities, and school settings; and developing guideline for disclosure of children with HIV/AIDS in Ethiopian context will increase the rate of disclosure of children’s HIV positive status on highly active antiretroviral therapy.