Disclosure to HIV-seropositive children in rural Zambia

Shinya Tsuzuki,Janet Watala,Hideki Miyamoto,Albert Mwango,Nangana Kayama,Naoko Ishikawa,Christopher Dube

doi:10.1186/s12887-018-1252-2

Shinya Tsuzuki, Janet Watala + Show 5 more

Open Access

https://doi.org/10.1186/s12887-018-1252-2

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Abstract

BackgroundCare of children living with HIV comprises various issues, some considered challenging. One of the challenging areas is the serostatus disclosure to HIV-positive children. This study describes the current situation of HIV disclosure among rural children in Zambia and examines the socio-demographic factors promoting disclosure.MethodsWe used a mixed method approach applying both quantitative and qualitative methods to obtain comprehensive picture of HIV serostatus disclosure for children. Data were collected in Mumbwa district, Zambia (2010–2012), included 57 clinical records of children older than 5 years old. We examined children’s age, gender, and cohabitation status with their parents, caregivers’ level of education and income, and the relation between children and caregivers. Logistic regression model was applied to examine associations between disclosure and socio-demographic characteristics. Semi-structured interviews with 50 caregivers and 22 HIV-positive children were conducted to qualitatively investigate attitude towards disclosure and support needed.ResultsFull disclosure was completed in 17 out of 57 (29.8%) patients. Median ages of patients in disclosed group and non-disclosed group were 10 and 9, respectively (IQR 8.0–13.0, 7.0–11.25). In univariate analyses, older age and male gender has positive relation to the completion of serostatus disclosure. In logistic regression models, cohabitation status with patients’ mothers showed positive correlation to the completion of serostatus disclosure. In the interviews with caregivers, all caregivers said that disclosure of serostatus is a necessary process and good for their children, while actual serostatus disclosure rate was low.ConclusionSerostatus disclosure to HIV-seropositive children is not prevalent in Rural Zambia. Although further researches would be desirable, increased support to caregivers would be beneficial.

Highlights

Care of children living with Human Immunodeficiency Virus (HIV) comprises various issues, some considered challenging
In 2015 an estimated 1.8 million children under the age of 15 years were living with HIV and about 150,000 children were newly infected with HIV [1]
We reviewed 57 out of 193 patients who were registered at antiretroviral therapy (ART) clinic in Mumbwa District Hospital, Zambia from 2005 to 2011

Summary

Introduction

Care of children living with HIV comprises various issues, some considered challenging. One of the challenging areas is the serostatus disclosure to HIV-positive children. This study describes the current situation of HIV disclosure among rural children in Zambia and examines the socio-demographic factors promoting disclosure. In 2015 an estimated 1.8 million children under the age of 15 years were living with HIV and about 150,000 children were newly infected with HIV [1]. HIV treatment and care for children involves various challenges including disclosure of HIV status [4]. WHO recommends disclosure of HIV status to HIV-seropositive children aged 6–12 years if they are mature enough to understand the disease [12]. In Zambia, it is recognized that mature children are usually able to deal with the realities of HIV. To date only few studies have examined the implementation of and factors associated with serostatus disclosure in Zambia [10, 14]

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