HIV Sero Status Disclosure by Caregivers to Infected Children Accessing Care at Mbagathi Hopsital, Nairobi City County, Kenya

Abstract

Background: HIV status disclosure to children is key to comprehensive pediatric HIV care. Increased access to antiretroviral drugs (ART) has led to survival of infected children posing a new challenge to parents on whether, when or how to disclose. Objective: To understand the prevalence, correlates and caregivers‟ perspectives on disclosure to HIV infected children on ART. Methodology: A mixed methods study with an analytic cross-sectional design for the quantitative aspect of the study was done. The target population was caregivers to HIV infected children aged 6 to 14 years receiving HIV care at Mbagathi Hospital, Kenya. Data was collected using questionnaires and interview guides. Chi-square and logistic regression were used to determine predictors of disclosure while thematic analysis was done for qualitative data. Results: Disclosure prevalence was 36% (n=254). Age 10-14 compared to 6-9 years (aOR=10.97; 95% CI=5.7-21.2; p<0.0001), longer duration on HIV care (aOR=1.91; 95% CI=1.02-1.97; p<0.0001) for >5 years compared to <1 year, which was similar to 1-5years duration (aOR=1.03; 95% CI=0.36-1.97; p=0.233) and perceived importance of disclosure (aOR=2.58; 95% CI=1.36-4.90; p=0.004) were significantly associated with disclosure. Fear of stigma and discrimination was associated with low disclosure (OR=0.931; 95% CI=0.44-151; p<0.0001). Caregiver‟s perceptions of importance of disclosure and influence of socio-cultural factors influenced disclosure. Conclusion: Disclosure prevalence was low (36%) despite high caregivers‟ perception of disclosure as important. Age of child, child‟s duration on care, caregivers‟ perceptions importance of disclosure and socio-cultural factors were associated with increased disclosure.