DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20192325

Pattern of disease disclosure to patients in pediatric HIV clinic in a tertiary care center in Kerala

Priya S., Lathika Nayar, Purushothaman K. K.

Abstract


Background: The pattern and rates of disclosure of HIV status to infected children may differ within a country, and among the states, based on the socioeconomic, cultural, and even health status. Understanding this pattern is important in the formulating guidelines of disclosure on their HIV diagnosis to children infected by HIV, and to design strategies for improvement of adherence. This study was proposed to study the pattern of disclosure of HIV status in children aged 6 to 17 years.

Methods: This cross sectional study was conducted for a year (2016-2017) at a Pediatric HIV clinic in Thrissur, Kerala. Participants for this study were 58 HIV-infected children in the age group of 6-17 years who were on ART, and their parents/caregivers.

Results: Among the 58 participants, only 25 (43.1%) were aware of their HIV status, either fully (17; 68%) or partially (8; 32%). Healthcare providers were more likely to disclose the status to the affected child. Majority of the participants (84%) had better compliance to therapy after disclosure and most of the children in the non-institutional group were more supportive towards their parents (50%) after disclosure. The factors that were associated with disclosure in the non-institutional group were age of the child and duration of therapy.

Conclusions: Children infected with HIV showed better adherence after complete disclosure. Rate of disclosure can be improved by reviewing the disclosure hurdles in our state so that intervention programs can be planned for improving the rate of disclosure.


Keywords


Disease status, Pediatric HIV, Disclosure, Caregiver

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References


World Health Organization. Geneva, Switzerland: World Health Organization; 2010. Antiretroviral therapy for HIV infection in infants and children: towards universal access, 2010.

American Academy of Pediatrics Committee on Pediatric AIDS. Disclosure of illness status to children and adolescents with HIV infection. American Academy of Pediatrics Committee on Pediatrics AIDS. Pediatrics. 1999;103(1):164–6.

Menon A, Glazebrook C, Campain N, Ngoma M. Mental health and disclosure of HIV status in Zambian adolescents with HIV infection: implications for peer-support programs. J Acquir Immune Defic Syndr. 2007;46(3):349–54.

Ferris M, Burau K, Schweitzer AM, Mihale S, Murray N, Preda A, et al. The influence of disclosure of HIV diagnosis on time to disease progression in a cohort of Romanian children and teens. AIDS Care. 2007;19(9):1088–94.

Vreeman RC, Gramelspacher AM, Gisore PO, Scanlon M, Nyandiko WM. Disclosure of HIV status to children in resource-limited settings: a systematic review. J Int AIDS Soc. 2013;16(1):18466.

Ghanashyam B. India failing children orphaned by AIDS. The Lancet. 2010;375(9712):363-4.

Arun S, Singh AK, Lodha R, Kabra Sk. Disclosure of the HIV infection status in children. Indian J Pediatr. 2009;76(8):805-8.

Bhattacharya M, Dubey AP, Sharma M. Patterns of Diagnosis, disclosure and its correlates in HIV infected North Indian Children. J Trop Pediatr. 2011;57(6):405-11.

Kodyalamoole NK, Badiger S, Kiran U, Dodderi SK, Rewari BB. Pattern of pediatric HIV status disclosure in coastal Karnataka. Indian J Med Res. 2018;147(5):501-6.

Beena ET, Suresh C, Sujatha V, Vijayalakshmi R, Watson B, Sowmya S. Are parents telling their children and what are some factors influencing disclosure – A study from South India. Int J Pub Health Epidemiol. 2013;2(5):108-3.

Kuppuswamy B. Manual of Socio-economic status scale (urban). Delhi; Manasyan; 1981.

Bhatia A, Ruducha J, Semrau K, Mann C, Lunstead J, Kumar P, Simon J. Disclosure of children’s HIV status in four high prevalence states in India. Research Report. Boston University OVC-CARE project. Available at: https://www.snehagram.org/ files/publications/studies1_April_2012.pdf. Accessed on 2 January 2019.

Menon A, Glazebrook C, Campain N, Ngoma M. Mental health and disclosure of HIV status in Zambian adolescents with HIV infection: implications for peer-support programs. J Acquir Immune DeficSyndr. 2007;46(3):349–54.

Bachanas PJ, Kullgren KA, Schwartz KS, et al. Predictors of psychological adjustment in school-age children infected with HIV. J Pediatr Psychol. 2001;26(6):343–52.

Bikaako-Kajura W, Luyirika E, Purcell DW. Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda. AIDS Behav. 2006;10(4 Suppl):S85–93.

Lee CL, Johann-Liang R. Disclosure of the diagnosis of HIV/AIDS to children born of HIV-infected mothers. AIDS Patient Care STDS. 1999;13(1):41–5.

Cohen J, Reddington C, Jacobs D, Meade R, Picard D, Singleton K, et al. School-related issues among HIV-infected children. Pediatrics. 1997;100(1):E8.