Abstract：
BACKGROUND: In recent years, the life expectancy of human immunodeficiency virus (HIV)-infected children has increased with the availability of highly active antiretroviral therapy (ART). Regardless of the clinical recommendations encouraging HIV status disclosure, the practice of caregiver disclosure is frequently challenging due to many constraints associated with caregivers and healthcare personnel. As studies suggest, disclosure of the HIV-positive status of children is low, particularly in sub-Saharan Africa, where the majority of infected children reside. Thus the primary objective of this study was to evaluate the prevalence of HIV-positive status disclosure to infected children and the pertinent factors associated with caregivers of these children. Moreover, unlike previous studies conducted in Ethiopia, this study included children residing in orphanages.
METHODS: We assessed HIV-positive status disclosure and associated factors among infected children in Hawassa, southern Ethiopia, from 25 May to 20 July 2021. A facility-based cross-sectional study was conducted in six public health facilities that provide HIV treatment and care. Data were collected from 355 randomly selected caregivers using interviewer-administered questionnaires and record reviews. Binary and multiple logistic regression was used to explore the association between independent variables and the outcome. The adjusted odds ratio (aOR) with 95% confidence interval (CI) was computed to determine the strength of the association and a p-value <0.05 was considered statistically significant.
RESULTS: Of the 355 children, 132 (37.2%) were informed about their HIV-positive status. Being of young age (≤12 y) (aOR 0.52 [95% CI 0.28 to 0.98]), having caregivers who were not familiar with anyone who disclosed children\'s HIV status (aOR 0.28 [95% CI 0.16 to 0.49]), children with a family that had a primary education (aOR 0.46 [95% CI 0.23 to 0.89]) and being a child who has taken ART for <5 y (aOR 0.47 [95% CI 0.28 to 0.80]) had a significant association with non-disclosure of HIV-positive status to infected children.
CONCLUSIONS: The findings show that disclosure of HIV-positive status to infected children is low. This suggests the need to provide support and education to caregivers, facilitate experience-sharing sessions between caregivers who disclosed the HIV status to infected children and implement age-specific disclosure interventions for young children. In addition, it is important to provide support and counselling to the children when their HIV status is disclosed.
METHODS: We assessed HIV-positive status disclosure and associated factors among infected children in Hawassa, southern Ethiopia, from 25 May to 20 July 2021. A facility-based cross-sectional study was conducted in six public health facilities that provide HIV treatment and care. Data were collected from 355 randomly selected caregivers using interviewer-administered questionnaires and record reviews. Binary and multiple logistic regression was used to explore the association between independent variables and the outcome. The adjusted odds ratio (aOR) with 95% confidence interval (CI) was computed to determine the strength of the association and a p-value <0.05 was considered statistically significant.
RESULTS: Of the 355 children, 132 (37.2%) were informed about their HIV-positive status. Being of young age (≤12 y) (aOR 0.52 [95% CI 0.28 to 0.98]), having caregivers who were not familiar with anyone who disclosed children\'s HIV status (aOR 0.28 [95% CI 0.16 to 0.49]), children with a family that had a primary education (aOR 0.46 [95% CI 0.23 to 0.89]) and being a child who has taken ART for <5 y (aOR 0.47 [95% CI 0.28 to 0.80]) had a significant association with non-disclosure of HIV-positive status to infected children.
CONCLUSIONS: The findings show that disclosure of HIV-positive status to infected children is low. This suggests the need to provide support and education to caregivers, facilitate experience-sharing sessions between caregivers who disclosed the HIV status to infected children and implement age-specific disclosure interventions for young children. In addition, it is important to provide support and counselling to the children when their HIV status is disclosed.
摘要：
背景：近年来，随着高效抗逆转录病毒治疗(ART)的出现,人类免疫缺陷病毒(HIV)感染儿童的预期寿命增加.不管临床建议鼓励披露艾滋病毒状况，由于与护理人员和医疗保健人员相关的许多限制,护理人员披露的实践经常具有挑战性。正如研究表明的那样，对儿童艾滋病毒阳性状况的披露较低，特别是在撒哈拉以南非洲，大多数受感染儿童居住的地方。因此，这项研究的主要目的是评估感染儿童的HIV阳性状态披露的患病率以及与这些儿童的照顾者相关的相关因素。此外，与以前在埃塞俄比亚进行的研究不同，这项研究包括住在孤儿院的儿童。
方法：我们评估了Hawassa感染儿童的HIV阳性状态披露和相关因素，埃塞俄比亚南部,2021年5月25日至7月20日。在提供艾滋病毒治疗和护理的六个公共卫生设施中进行了基于设施的横断面研究。使用面试官管理的问卷和记录评论，从355名随机选择的护理人员中收集数据。使用二元和多元逻辑回归来探索自变量与结果之间的关联。计算具有95%置信区间(CI)的校正比值比(aOR)以确定关联的强度,并且P值<0.05被认为具有统计学意义。
结果：在355名儿童中，132（37.2％）被告知其HIV阳性状态。年龄较小（≤12岁）（aOR0.52[95%CI0.28至0.98]），照顾者不熟悉任何披露儿童艾滋病毒状况的人(aOR0.28[95%CI0.16至0.49])，家庭接受过初等教育的儿童(aOR0.46[95%CI0.23~0.89])和服用ART<5岁的儿童(aOR0.47[95%CI0.28~0.80])与未向感染儿童披露HIV阳性状态有显著关联.
结论：研究结果表明，对感染儿童的HIV阳性状态的披露较低。这表明需要向护理人员提供支持和教育，促进向感染儿童披露艾滋病毒状况的护理人员之间的经验分享会议，并为幼儿实施针对具体年龄的披露干预措施。此外,重要的是在披露儿童的艾滋病毒感染状况时向他们提供支持和咨询。
方法：我们评估了Hawassa感染儿童的HIV阳性状态披露和相关因素，埃塞俄比亚南部,2021年5月25日至7月20日。在提供艾滋病毒治疗和护理的六个公共卫生设施中进行了基于设施的横断面研究。使用面试官管理的问卷和记录评论，从355名随机选择的护理人员中收集数据。使用二元和多元逻辑回归来探索自变量与结果之间的关联。计算具有95%置信区间(CI)的校正比值比(aOR)以确定关联的强度,并且P值<0.05被认为具有统计学意义。
结果：在355名儿童中，132（37.2％）被告知其HIV阳性状态。年龄较小（≤12岁）（aOR0.52[95%CI0.28至0.98]），照顾者不熟悉任何披露儿童艾滋病毒状况的人(aOR0.28[95%CI0.16至0.49])，家庭接受过初等教育的儿童(aOR0.46[95%CI0.23~0.89])和服用ART<5岁的儿童(aOR0.47[95%CI0.28~0.80])与未向感染儿童披露HIV阳性状态有显著关联.
结论：研究结果表明，对感染儿童的HIV阳性状态的披露较低。这表明需要向护理人员提供支持和教育，促进向感染儿童披露艾滋病毒状况的护理人员之间的经验分享会议，并为幼儿实施针对具体年龄的披露干预措施。此外,重要的是在披露儿童的艾滋病毒感染状况时向他们提供支持和咨询。
