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Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment...

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Autores principales: Vreeman, Rachel C., Scanlon, Michael L., Marete, Irene, Mwangi, Ann, Inui, Thomas S., McAteer, Carole I., Nyandiko, Winstone M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685612/
https://www.ncbi.nlm.nih.gov/pubmed/26616121
http://dx.doi.org/10.1080/09540121.2015.1026307
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author Vreeman, Rachel C.
Scanlon, Michael L.
Marete, Irene
Mwangi, Ann
Inui, Thomas S.
McAteer, Carole I.
Nyandiko, Winstone M.
author_facet Vreeman, Rachel C.
Scanlon, Michael L.
Marete, Irene
Mwangi, Ann
Inui, Thomas S.
McAteer, Carole I.
Nyandiko, Winstone M.
author_sort Vreeman, Rachel C.
collection PubMed
description Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver–child dyads enrolled in the study, children’s mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child’s knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5–2.1), better WHO disease stage (OR 2.5, 95% CI 1.4–4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1–3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes.
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spelling pubmed-46856122016-01-04 Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya Vreeman, Rachel C. Scanlon, Michael L. Marete, Irene Mwangi, Ann Inui, Thomas S. McAteer, Carole I. Nyandiko, Winstone M. AIDS Care Original Articles Knowledge of one’s own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver–child dyads enrolled in the study, children’s mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child’s knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5–2.1), better WHO disease stage (OR 2.5, 95% CI 1.4–4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1–3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes. Taylor & Francis 2015-11-02 2015-11-29 /pmc/articles/PMC4685612/ /pubmed/26616121 http://dx.doi.org/10.1080/09540121.2015.1026307 Text en © 2015 The Author(s). Published by Taylor & Francis. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
spellingShingle Original Articles
Vreeman, Rachel C.
Scanlon, Michael L.
Marete, Irene
Mwangi, Ann
Inui, Thomas S.
McAteer, Carole I.
Nyandiko, Winstone M.
Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
title Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
title_full Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
title_fullStr Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
title_full_unstemmed Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
title_short Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya
title_sort characteristics of hiv-infected adolescents enrolled in a disclosure intervention trial in western kenya
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685612/
https://www.ncbi.nlm.nih.gov/pubmed/26616121
http://dx.doi.org/10.1080/09540121.2015.1026307
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