HIV-positive Parents Research Articles

Evaluating the Influence of Parental HIV Status on Well-being of Children and Adolescents in Lagos State, Nigeria

Background and Purpose: The quality of life (QoL) of children and adolescents living with HIV is a crucial area of public health concern, particularly in regions heavily impacted by HIV. Parental HIV status can significantly influence different dimensions of a child’s life, including their emotional, social, and physical health. Nigeria is one of the countries having the highest HIV prevalence rates; understanding how parental HIV status affects children is essential for designing effective intervention and support systems. This study aims to investigate the relationship between parental HIV status and health-related QoL (HRQoL) among children and adolescents. We hope to provide insights that can improve the lives of young individuals in Lagos State, Nigeria. By examining demographic factors and health-related variables, this research seeks to advise targeted strategies to support families affected by HIV. Materials and Methods: This retrospective study collected data at the Pediatric and Adolescent Clinic, the Clinical Sciences Department of the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos State, Nigeria, between May and July 2019. The Institutional Review Board of NIMR granted ethical approval for the study. The study population consisted of 113 children and young people with HIV. Participants were randomly selected and assessed for eligibility. Then, written informed consent was obtained before enrollment in the main study. Data on sociodemographic characteristics, HIV-related health metrics, and HRQoL were collected using a case record form and a validated questionnaire to assess the pediatric QoL (PedsQL). A total of 108 participants (60 with single parent HIV-positive and 48 with both parents HIV-positive) were included. The data were analyzed using STATA software, version 16, employing the chi-square test and logistic regression to examine the determinants influencing HRQoL. We employed the PedsQL version 4, and the clinician filled out the questionnaire in the Pediatric Clinic. Results: Participants’ mean ages were 13.6 years (single parent HIV positive) and 14.2 years (both parents HIV positive), with significant associations between age and parental HIV status (P<0.05). Fathers were primary caregivers for 46.7% (single parent HIV positive) and 56.3% (both parents HIV positive) of participants (P<0.05). Parental status (alive or deceased) and education level were significantly associated with parental HIV status, with most participants having secondary education. Most participants identified as Christians (86.7% single parent HIV positive and 87.5% both parents HIV positive). The CD4 cell counts below 500 were more common in participants with both parents HIV positive, though with no significant association (P>0.05). The HRQoL scores were significantly associated with parental HIV status (P<0.05), with better scores in psychosocial and physical domains. Logistic regression showed no significant links between parental HIV status and gender, age group, or primary caregiver’s gender. Participants with both HIV-positive parents were less likely to have both parents alive. Conclusion: Parental HIV status significantly affects demographic factors and HRQoL in children and adolescents. These findings highlight the necessity for specialized interventions and support mechanisms to enhance the QoL for families affected by HIV.

The nutritional well-being of children under five with HIV-positive parents at Bikurungu Health Center III in Rukungiri District

Families affected by HIV/AIDS often face food insecurity and malnutrition. In impoverished nations, over a third of infectious disease-related deaths in children under five result from poor nutrition. Household food insecurity and the impact of HIV/AIDS-related illnesses can hinder the growth of young children, leading to increased malnutrition. A study involving 310 mother/infant pairs from various households was conducted using a convenient sampling method. Information was gathered through a structured questionnaire. Analysis revealed that children in households affected by HIV had a significantly higher rate of stunting (height-for-age < –2 SD) compared to those in unaffected households (25.5% vs. 9.1%, p = .002). However, the rates of wasting and underweight did not significantly differ between HIV-affected and unaffected households. Living in households affected by HIV is associated with stunted growth in children under five. Keywords: HIV/AIDS, Children under 5 years of age, Malnutrition, Stunting

Participatory Methods for Stigma Reduction with HIV-Affected Families

HIV stigma contributes to risks for poor health; these risks are exacerbated by additional stigmas of race, gender, sexual orientation, and substance abuse history. As women continue to be infected by HIV and as people with HIV are living longer, their children, most of whom are not HIV infected, are affected by their parent’s HIV status. Children may feel stigma as acutely as their HIV-positive (HIV+) parents, contributing to the children’s vulnerability. Children of HIV+ mothers have more emotional problems, disrupted relationships, and poor school outcomes than those whose mothers are not living with HIV. As we learn about stigma’s impact beyond the individual, we are compelled to respond systemically within families to reduce future generations’ vulnerability to HIV and other risks. Based on a line of inquiry with HIV-affected teens about their stigma experiences, our multidisciplinary team discovered stigma’s impact on our ability, not only to study stigma, but to engage parents and especially their children in services and research. We draw on these findings and the literature on community-based participation to contend that participatory methods have value, not only for research and program development, but in reducing the impact of stigma with our HIV-affected partners. The participatory process is as important to stigma reduction as knowledge and service development outcomes. Participatory methods can expand our potential for breaking the cycle of intergenerational vulnerability by strengthening family skills and capacity and enhancing self-worth so those affected by HIV are empowered to overcome stigma’s impact.

Memory Book as a New Genre of Illness Writing: How a Ugandan Mother Wrote about HIV

A memory book is a therapeutic document and personal testament – a workbook written, most commonly, by a HIV-positive caregiver or parent for their child, about the family’s background and the parent’s life experiences, to guide the child in the parent’s absence. In Uganda, memory projects first emerged in 1998 as public health outreach for people with HIV. They encourage writers, often agrarian widows with limited literacy, to deliver their messages to their children and the world. While reports have focused on the psychosocial support the projects provide to the beneficiaries, the content, and modes of representation in individual books, have received little attention. This article undertakes a close textual analysis of the words and images in one memory book, written in English by a subsistence farmer with seven years’ schooling. Using the frameworks of narrative therapy and illness writing, it examines how this reticent writer represents, obliquely, through textual gaps and contradictions, her painful memories of her child’s abuse by her husband and her co-wife and the difficult experience of living with HIV. This article argues that memory books as a new genre of illness writing can help less literate, less heard people with HIV write their stories in their own words and can help us, the readers, understand their experiences and lifeworlds from their perspectives.

Effects of parental HIV on telomere length among children in rural China.

Cumulative evidence has shown the adverse effects of HIV-related death and illness on children's psychosocial well-being. However, few studies have examined whether these factors can "get under the skin" to affect children's health. This study, therefore, examined the effects of HIV-related parental death on telomere length, a biomarker of cellular aging. This study further explored whether the results on telomere length were consistent with results based on self-report health outcomes, namely depressive symptoms. A total of 117 children (10-17 years of age) affected by parental HIV (27 children living with HIV-positive parents and 90 AIDS orphans) from Henan China provided blood samples for telomere length assay and completed a survey for depressive symptoms and demographic information. Results showed that AIDS orphans had a shorter telomere length than children living with HIV-positive parents and that such differences in telomere length were more evident than were differences in depressive symptoms. There were no significant differences in telomere length or depressive symptoms between children who lost one parent and those who lost both. The results suggest that HIV-related parental death may contribute to accelerated telomere shortening and highlight that telomere length may be a novel and useful biomarker for health needs assessment in pediatric AIDS care. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Concerns of Parental HIV Disclosure in China.

Although parental HIV disclosure has benefits for parents and children, the disclosure rate among parents remains low. This study aims to qualitatively examine parental concerns regarding disclosure of their HIV status to their children. Eighty parents were enrolled in a randomized controlled trial of a three-session disclosure-support intervention, with forty receiving the intervention and forty receiving treatment as usual. Intervention sessions were audio recorded, and transcriptions were qualitatively coded for content related to concerns of disclosure. Four themes emerged: Intention to disclose, disclosure approach, indicators for disclosure, and fears about disclosure. These themes reveal struggles that parents experience when considering HIV disclosure suggesting that an effective disclosure intervention must help parents assess pros and cons, discuss the emotions of the children after the disclosure, and monitor the impact on children's lives after disclosure over time. Future research is needed to implement interventions supporting HIV-positive parents' disclosure decision-making and actions.

A cross-sectional study on caregivers\u2019 perspective of the quality of life and adherence of paediatric HIV patients to highly active antiretroviral therapy

BackgroundPoor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.MethodsWe conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children’s Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee.ResultsThe study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p = 0.019*) to the physical health domain (mean = 64.61 SD = 8.1). Caregiver HIV status showed a strong association with the physical (mean = 58.3, SD = 11.7 and p = 0.024*), and psychological health domains (mean = 68.2, SD = 14.7 and p = 0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean = 58.0, SD = 10.6, p < 0.001), psychological (mean 68.2 SD = 14.81 p < 0.001) and environmental health domains (mean = 59.7, SD = 13.47, p < 0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p = 0.014) and adherent paediatric patients (p = 0.005). Nuclear family also showed a strong association with psychological (p < 0.001) and environmental (p = 0.001) health domains.ConclusionThis study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.

Effectiveness of symptom-based diagnostic HIV testing versus targeted and blanket provider-initiated testing and counseling among children and adolescents in Cameroon.

ObjectivesThe concurrent implementation of targeted (tPITC) and blanket provider-initiated testing and counselling (bPITC) is recommended by the World Health Organization (WHO) for HIV case-finding in generalized HIV epidemics. This study assessed the effectiveness of this intervention compared to symptom-based diagnostic HIV testing (DHT) in terms of HIV testing uptake, case detection and antiretroviral therapy (ART) enrollment among children and adolescents in Cameroon, where estimated HIV prevalence is relatively low at 3.7%.MethodsIn three hospitals where DHT was the standard practice before, tPITC and bPITC were implemented by inviting HIV-positive parents in care at the ART clinics to have their biological children (6 weeks-19 years) tested for HIV (tPITC). Concurrently, at the outpatient departments, similarly-age children/adolescents were systematically offered HIV testing via accompanying parents/guardians. The mean monthly number of children tested for HIV, identified HIV-positive and ART-enrolled were used to compare the outcomes of different HIV testing strategies before and after the intervention.ResultsIn comparing DHT to bPITC, there was a significant increase in the mean monthly number of children/adolescents tested for HIV (223.0 vs 348.3, p = 0.0073), but with no significant increase in the mean monthly number of children/adolescents: testing HIV-positive (10.5 vs 9.7, p = 0.7574) and ART- enrolled (7.3 vs 6.3, p = 0.5819). In comparing DHT to tPITC, there was no significant difference in the mean monthly number of children/adolescents: tested for HIV (223 vs 193.8, p = 0.4648); tested HIV-positive (10.5 vs 10.6, p = 0.9544), and ART-enrolled (7.3 vs 5.8, p = 0.4672). When comparing DHT versus bPITC+tPITC, there was a significant increase in the mean monthly number of children/adolescents: tested for HIV (223.0 to 542.2, p<0.0001), testing HIV-positive (10.5 vs 20.3, p = 0.0256), and ART-enrolled (7.3 vs 12.2, p = 0.0388).ConclusionsThese findings suggest that concurrent implementation of bPITC+tPITC was more effective compared to DHT in terms of HIV testing uptake, case detection and ART enrolment. However, considering that DHT and bPITC had comparable outcomes with regards to case detection and ART enrolment, bPITC+tPITC may not be efficient. Thus, this finding does not support concurrent bPITC+tPITC implementation as recommended by WHO. Rather, continued DHT+tPITC could effectively and efficiently accelerate HIV case detection and ART coverage among children and adolescents in Cameroon and similar low-prevalence context.

Needs must: living donor liver transplantation from an HIV-positive mother to her HIV-negative child in Johannesburg, South Africa

The world’s first living donor liver transplant from an HIV-positive mother to her HIV-negative child, performed by our team in Johannesburg, South Africa (SA) in 2017, was necessitated by disease...

Diurnal Cortisol in a Sample of Socioeconomically Disadvantaged Chinese Children: Evidence for the Shift-and-Persist Hypothesis.

Low socioeconomic status (SES) is one of the most well-established social determinants of health. However, little is known about what can protect the health of individuals (especially children) living in low-SES circumstances. This study explored whether the psychological strategy of "shift-and-persist" protects low-SES children from stress-related physiological risks, as measured through blunted (unhealthy) diurnal cortisol profiles. A sample of 645 children (aged 8-15 years) from low-SES backgrounds and having at least one HIV-positive parent completed a battery of psychological scales. Diurnal cortisol assessments included collection of saliva samples four times a day for 3 days, from which three cortisol parameters (cortisol at awakening, cortisol awakening response, and cortisol slope) were derived. Higher levels of shift-and-persist, considered as a single variable, were associated with higher cortisol at awakening (B = 0.0119, SE = 0.0034, p < .001) and a steeper cortisol slope (B = -0.0007, SE = 0.0003, p = .023). These associations remained significant after adjusting for covariates and did not vary by age. In supplementary analyses, where shifting and persisting were treated as separate variables, the interaction between these two coping strategies significantly predicted cortisol at awakening (B = 0.0250, SE = 0.0107, p = .020) and the cortisol slope (B = -0.0022, SE = 0.0011, p = .040), suggesting that the combination of shift-and-persist is important for predicting diurnal cortisol profiles. Our findings demonstrate that shift-and-persist is associated with healthier diurnal cortisol profiles among socioeconomically disadvantaged children and introduce the possibility that this coping strategy is protective against other stressors, such as those uniquely faced by children in our study (i.e., being affected by parental HIV).

Stigma as experienced by children of HIV-positive parents: a narrative review

ABSTRACTThis narrative review examines the effects on children of stigma by association with an HIV-positive parent. It expands on previous reviews by including all HIV-affected children, whether orphaned or living with a parent with HIV, and considers the broad effects of stigma-by-association (SBA), including but not limited to the psychological impact. Studies met the following criteria – sample included children, ages 6–19 years old, who were not HIV-positive but were currently living with or had lived with a parent who was HIV-positive (i.e., AIDS orphans). Study findings included children’s perspectives on stigma and were available in English. Studies for inclusion were identified by searches in Psychinfo, Proquest, and PubMed from 1996 through 2016. This review substantiates that children across countries and cultures experience HIV SBA. SBA is associated with psychological or emotional problems, disrupted peer and adult relationships, and poor school outcomes for children. Orphans were more likely than children living with positive parents to experience negative outcomes, which can have a long-term impact. Felt stigma was as prevalent as enacted stigma and may become the focus of intervention as HIV disease increasingly becomes a concealable disease. The review findings also point to the complexity of relationships between SBA and variables such as poverty and mental health and the bi-directional relationship between SBA and depression. We adapt a stigma framework developed for people living with HIV (PLWHIV) to structure the results of this review. With these findings, we can develop interventions that support stigma reduction with children and their parents, responding to the wide range of stigma consequences and customized to the children’s family and cultural context.

Parental Disclosure of Own HIV Status to Children in Two Ghanaian Regions; Examining the Determinants within a Child Vulnerability Context

Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P < 0.05 and binary logistic regression to find out the predictors of parental HIV status disclosure to children. Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4; 95% CI: 1.08 - 10.66, P < 0.036), disclosing to HIV positive child (OR = 169.9, 95% CI: 34.16 - 845.32, P < 0.000), parental perception of disclosure improving child wellbeing (OR = 10.6, 95% CI: 1.48 - 76.08, P < 0.019) and parental knowledge of someone else having disclosed status to children (OR = 5.9, 95% CI: 2.13 - 16.42, P < 0.001). None of the variables showed a significant independent association with parental disclosure when adjusted in the multivariate logistic regression. The dominant barrier to disclosure concerned parental view that children may not understand the disclosure and the parents’ discomfort on finding answers to child potentially questioning parent on how the parent got infected with HIV. Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.

Designing a Need Based Social Protection Intervention Package for Children and Adolescents Living with HIV and AIDS in Ghana—An Eclectic Perspective on Desired Social Protection Intervention Package/Framework

Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.

Having children outside a heterosexual relationship: options for persons living with HIV

This article presents information about the social, legal and medical issues that medical and non-medical practitioners in the UKi should consider in order to signpost options for people living with...

Active case finding: comparison of the acceptability, feasibility and effectiveness of targeted versus blanket provider-initiated-testing and counseling of HIV among children and adolescents in Cameroon

BackgroundChildren and adolescents still lag behind adults in accessing antiretroviral therapy (ART), which is largely due to their limited access to HIV testing services. This study compares the acceptability, feasibility and effectiveness of targeted versus blanket provider-initiated testing and counseling (PITC) among children and adolescents in Cameroon.MethodsDuring a 6-month period in three hospitals in Cameroon, we invited HIV-positive parents to have their biological children (6 weeks-19 years) tested for HIV (targeted PITC). During that same period and in the same hospitals, we also systematically offered HIV testing to all children evaluated at the outpatient department (blanket PITC). Children of consenting parents were tested for HIV, and positive cases were enrolled on ART. We compared the acceptability, feasibility and effectiveness of targeted and blanket PITC using Chi-square test at 5% significant level.ResultsWe enrolled 1240 and 2459 eligible parents in the targeted PITC (tPITC) and blanket PITC (bPITC) group, and 99.7% and 98.8% of these parents accepted the offer to have their children tested for HIV, respectively. Out of the 1990 and 2729 children enrolled in the tPITC and bPITC group, 56.7% and 90.3% were tested for HIV (p < 0.0001), respectively. The HIV positivity rate was 3.5% (CI:2.4–4.5) and 1.6% (CI:1.1–2.1) in the tPITC and bPITC (p = 0.0008), respectively. This finding suggests that the case detection was two times higher in tPITC compared to bPITC, or alternatively, 29 and 63 children have to be tested to identify one HIV case with the implementation of tPITC and bPITC, respectively. The majority (84.8%) of HIV-positive children in the tPITC group were diagnosed earlier at WHO stage 1, and cases were mostly diagnosed at WHO stage 3 (39.1%) (p < 0.0001) in the bPITC group. Among the children who tested HIV-positive, 85.0% and 52.5% from the tPITC and bPITC group respectively, were enrolled on ART (p = 0.0018).ConclusionsThe tPITC and bPITC strategies demonstrated notable high HIV testing acceptance. tPITC was superior to bPITC in terms of case detection, case detection earliness and linkage to care. These findings indicate that tPITC is effective in case detection and linkage of children and adolescents to ART.Trial registrationTrial registration Number: NCT03024762. Name of Registry: ClinicalTrial.gov. Date registration: January 19, 2017 (‘retrospectively registered’). Date of enrolment first patient: 15/07/2015.

Resilience strategies of HIV-positive parents who live with children within the family context in Bangladesh

ABSTRACTWe have limited knowledge about the vulnerabilities faced by HIV-positive parents in families and the strategies they use to manage these circumstances in Bangladesh. A qualitative research design was used to analyse in-depth interviews with 19 HIV-positive parents who lived with their children in Khulna and Dhaka, Bangladesh. The findings indicate that resilience of HIV-positive parents was fostered through interaction with informal and formal social networks. The findings of this study demonstrate that social support groups can play a crucial role to construct new ways of coping and reintegrate HIV people into their families and society.

The role of children in their HIV-positive parents’ management of antiretroviral therapy in Uganda

Adjustment to life on antiretroviral therapy (ART) and living with HIV as a long-term chronic condition, pose significant medical, social and economic challenges. We investigated children’s role in supporting HIV-positive parents to self-manage life on ART. Between 2010 and 2012, we conducted a qualitative study using semi-structured interviews with 38 HIV-positive parents who had been on ART for over a year. They were randomly selected from people accessing ART from three delivery sites in Wakiso district, Uganda. Data were analysed thematically. Participants reported children between the ages of 1 and 47 years providing support. Children were a source of happiness, self-worth, encouragement, and comfort. Both younger and older children supported parents’ adherence to treatment through reminding them to take the drugs and honour clinic appointments. Older children provided money to buy medication, food and shelter. Parents reported that the encouragement they received after they disclosed to their children enhanced their survival. After HIV disclosure to their children many of their fears about the future were allayed. Thinking about their children’s future brought hope. However, looking after younger children while on ART could be burdensome since some parents could not work to their full capacity due to reduced physical health. Children are an important resource in their parents’ adjustment to living with HIV while taking ART. There is a need for children to be supported by appropriate policy and other social and health development structures.

PROSES DISCLOSURE DAN KONDISI PSIKOSOSIAL ANAK DENGAN HIV/AIDS

&lt;br /&gt;&lt;table class="data" width="100%"&gt;&lt;tbody&gt;&lt;tr valign="top"&gt;&lt;td class="value"&gt;&lt;p&gt;HIV-infected children have a longer life expectancy after the invention of antiretroviral treatment. Therefore, a well-prepared HIV status disclosure become a significant issue for children living with HIV/AIDS (CLWHA). Previous studies have shown that disclosing a status of children with chronic illness helps them to cope with the illness. However, delayed disclosure for various reasons which often influenced by parents or caregivers consideration affect children’s psychosocial condition. This paper will illustrate the psychosocial condition of CLWHA in relation to the preparation of their disclosure process.This descriptive study used a qualitative approach with observations, indepth interviews, and Focus Group Discussion on CLWHA and their parents/caregivers.Not all disclosed CLWHA has a good psychosocial function. The disclosure are affected by the process and the disclosure level. A HIV disclosed child of HIV positive parents has better psychosocial conditions than a child whose disclose are prepared by a pediatrician or than those who partially disclosed by themselves.Disclosing HIV/AIDS status has significantly affected the psychosocial condition of CLWHA. Therefore, it needs to be carefully well planned and well prepared by taking into account the condition of ADHAs and their caregivers to avoid involuntary disclosure.The government needs to formulate policies on disclosure process for CLWHA to maintain the psychosocial condition of the children so that their quality of life can be better increased.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;

P142 Challenges and opportunities of a ‘Look Back’ exercise on child testing

Background/introduction The consensus document ‘Don’t forget the children’ 2009 recommends that all HIV units perform a ‘look back’ exercise to establish the HIV status of children whose HIV positive parents attend that service, as a standard of care. Aim(s)/objectives To perform a ‘look back’ to identify children born to HIV positive females in our unit. Determine their HIV testing status and establish a robust pathway for testing and recording outcome. Methods A retrospective notes review of all HIV positive women registered with the Sexual Health Clinic. Results 76 women identified, 66 had 149 children. Ethnicity was predominantly African (38/76). 48/76 women acquired infection abroad. Children at risk of vertical HIV transmission recognised in 53/66 women. Child testing identified and documented in 29/53 women (65 children); 8 were HIV positive. 10/53 had children resident abroad (23 children). Parental discussions on-going in 6/53 women. A further 3/53 women declined testing. In 3/53 records were incomplete and 2/53 testing in progress. Discussion/conclusion Challenges of retrospectively identifying children at risk of undiagnosed HIV highlighted particularly in parents that have not disclosed their status to children. We identified a reliance on verbally reported documentation as evidence of child testing, the challenges of testing older children and the need for robust reporting between paediatric and adult services. Clinicians should continue to ask about children abroad who subsequently join parents in the UK to avoid missed opportunities for testing.

Peculiarities of Childrencare and Psycho-Pedagogical Rehabilitation of Children Born from HIV-Positive Parents

This article analyzes the experience in psychological and educational rehabilitation of children born from HIV-positive parents in the age from 2 months to 7 years. Working with children in this category is held in the Regional Specialized Children's Home “Zelenyy Нay”, Ukraine, Kharkov.The article describes the features of the rehabilitation and education of such children. In the literature, this problem is almost not covered. Therefore, the work was carried out individually with each child and the methods of pedagogical activity and social adaptation of children have been improved. It has been revealed that the children who had the coefficient of intellectual development close to normal children had undue fatiguability associated with a primary diagnosis. Taking into account this feature of children born from HIV-positive parents, changes were made in the structure of employment, the schedule of the day and individual approaches to each child.