20th International AIDS Conference - Melbourne, Australia


WEPE243 - Poster Exhibition

Current situation of serostatus disclosure to HIV-positive children and its associated factors in Mumbwa district, Zambia

C. Dube1,2, S. Tsuzuki3, J. Watala1,2, N. Kayama1,2, N. Ishikawa3, K. Komada2,3, H. Miyamoto2,3, A. Mwango2,4

1Mumbwa District Community Health Office, Mumbwa, Zambia, 2MOH Zambia - JICA SHIMA Project, Lusaka, Zambia, 3National Center for Global Health and Medicine, Tokyo, Japan, 4Ministry of Health, Lusaka, Zambia

Background: HIV serostatus disclosure to HIV positive children is an important issue in paediatric HIV care and treatment. The evidence suggests health benefit of disclosure and WHO recommends that school aged children should be told their HIV status. The main objective of this study is to examine the current situation of HIV serostatus disclosure to HIV-infected children and to identify factors associated with the disclosure in a rural setting of Zambia.
Methods: Clinical records of 193 paediatric HIV patients who had been enrolled at HIV clinic in Mumbwa district hospital between March 2005 and February 2011 were reviewed with focus on the serostatus disclosure, characteristics, and treatment outcomes of children. Semi-structured face-to-face interviews on caregivers'' attitudes and behaviours towards disclosure and children''s understandings on their disease and experiences of disclosure were also conducted targeting children and their caregivers between November 2010 and March 2012, in which 23 HIV-infected children and 58 caregivers participated.
Results: Information on HIV disclosure was available from 66 cases of clinical records, in which 18 children (27.3%) were reported to be aware of their status. It was found that the age of children was closely associated with disclosure. While children aged 0-5 years were generally not informed about their status, children above 11 years were more likely to be informed (p=0.038). Cohabitation status with parents was significantly associated with disclosure, in which children living with their mothers were more likely to know their status as compared to the other children (58.3% vs. 13.3%, p=0.023). All the caregivers interviewed said that children should know their serostatus and majority said family member should play the main role in disclosure with support of health workers. Among 23 children interviewed, 3 children aged 12-13 years, all of them were informed by their parents, one with support from a health worker, described their experiences in disclosure.
Conclusions: Caregivers of HIV-infected children have positive attitudes towards HIV serostatus disclosure and family members, especially mothers are playing an important role. Support from health workers would further help HIV serostatus disclosure to children.

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