Practices, perspectives and barriers of HIV disclosure to children and adolescents by Health care workers; in Addis Ababa health facilities, Ethiopia
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Date
2017-12
Authors
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Publisher
Addis Ababa Universty
Abstract
Introduction
According to 2016 global HIV statistics, in 2016, globally there are an estimated 36.7
million people living with HIV of which 25. 5 million are in sub‐Saharan Africa and 1.8
million are children .In Ethiopia, by 2017, there are estimated 722,248 people living with
the virus of which 57,132 are children up to the age of 14 years according to the Ethiopian
public health institute. Survival of perinatally infected children into adolescence and
beyond made disclosure a major challenge for caregivers and healthcare professionals
providing service to HIV‐infected children. Although disclosure is associated with
improved adherence to HAART and attendance to follow up clinics, there are significant
numbers of children and adolescents who are receiving treatment without being fully
informed about their HIV status because many health care workers fear that disclosure
may create distress for the child.
Objectives
The objective of this research was to assess the practices, perspectives and barriers of
pediatric HIV disclosure among health care workers in Addis Ababa health facilities,
Ethiopia
Methodology
A quantitative cross sectional study design was conducted at health facilities taking care
of pediatric HIV patients (both adult and pediatric ART clinics) in Addis Ababa, Ethiopia
from June 1, 2017 to July 30, 2017. A structured, standardized and pretested questionnaire
was used to asses 138 HCWs during the study period. Data was collected by trained nurses
through self‐administration. Collected data was edited, coded, entered and analyzed
using Statistical package for social science (SPSS) version 20. The results were presented
with percentages, frequency tables and figures. Bivariate analysis was done to test the
association between pediatric HIV status disclosure by HCPs and different factors of the
health care workers. To identify the independent predictors of disclosure to children by
HCPs, we did multivariable logistic regression.
Results
A total of 138 HCPs included in the study the majority 96(69.6%) were females and nurses
account more than half of the participants 75 (54.3%).More than half of the health care
workers 76 (55.1%) had work experience of 5 to 10 years. Though most of HCPs
134(97.1%) believed children will benefit if they are disclosed, more than one third (36.2%)
of them have not ever disclosed a child. Training on pediatric HIV disclosure
[AOR=6.264; 95%CI: 1.978‐19.841, p value =0.001] and availability of guidelines for
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disclosure [AOR =8.350; 95%CI: 1.737‐40.126, p value =0.001] independently increased the
odds of HIV positive status disclosure to children by HCPs.
Conclusion and Recommendations
Unavailability of guidelines at the health facilities and lack of training on pediatric HIV
disclosure for HCPs have been found healthcare providers constraints in the process of
disclosure.
Improved training and availability of guidelines on pediatric HIV disclosure would
alleviate the discrepancies that exist among healthcare providers on this issue.
Description
Keywords
HIV, Disclosure, Health care provider, Disclosure guidelines, Perinatally infected children, Caregivers.