Factors Determining Disclosure by Parents among Children Living with HIV/AIDS Attending the Center of Excellence in Kigali University Teaching Hospital

ABSTRACT

"The increasing access to antiretroviral therapy (ART) and survival of HIV-infected children has raised challenges on disclosing HIV diagnosis to children. Many parents and guardians are reluctant to allow children living with HIV to know their status; arguing that they are too young and will not understand fully their circumstances causing emotional disturbances as a result. There are further concerns that children may blame their parents and ask questions on how they got the disease; even inadvertently ""blurting out the secret"" and thus exposing the family to stigma and discrimination. In this cross-sectional study; eligible children were recruited to participate. Data on these children was obtained from the electronic databases and completed with data extraction from the individual patient fie. A sample of both parents and guardians who disclosed and those who did not disclose have been interviewed to identify the factors and reasons behind their decision-making process in addition to what they believe would improve their disclosure. A total of 64of HIV positive (HIV+) children had their status disclosed to them by parents while 35.8 did not. The majority of parents or guardians (80) found that disclosing status improved adherence. A large number of parents or guardians (67) attended psychosocial support groups and accordingly disclosure status was highly associated with psychosocial support group attendance (p0.05). Disclosure and statistical tests showed that disclosure status was highly associated with CD4 outcomes (p0.05). In addition; disclosure status was highly associated with viral load outcome (p0.05). Moreover; 64.4 of children living with HIV underwent an increase of weight greater or equal 4 kg after disclosure and statistically disclosure status was highly associated with weight outcomes (p0.05)."