Thyna Orelly1, Henry Welch2,3, Edwin Machine2,3, Wendy Pameh2, Trevor Duke2,4,5. 1. Department of Paediatrics, Port Vila Central Hospital, Port Vila, Vanuatu. 2. Discipline of Child Health, University of PNG School of Medicine and Health Sciences, Port Moresby, Papua New Guinea. 3. Global Health, Baylor College of Medicine, Houston, Texas, United States. 4. Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia. 5. Intensive Care Unit, Royal Children's Hospital, Melbourne, Victoria, Australia.
Abstract
AIM: How to provide human immunodeficiency virus (HIV) disclosure and awareness for children and young people has not been studied in Papua New Guinea or Pacific Island countries. We aimed to determine the current practices of HIV disclosure and evaluate whether an incremental disclosure education model, as recommended by World Health Organization (WHO), would increase children's knowledge about their condition and improve adherence to antiretroviral therapy (ART). METHODS: We enrolled HIV-infected children on ART whose parents consented, and we identified whether they were aware that they were HIV positive or not. An incremental education model was used to teach the children about their illness and to disclose their HIV status if that was the parents' wishes. Knowledge of HIV and adherence to ART before and following education sessions was assessed. RESULTS: A total of 138 children HIV-positive children were recruited. Only 7% had previously been made aware of their HIV test results; the mean disclosure age was 12.7 years. By 10 years of age, 25 of 34 participants (74%) had not been told they had HIV. The common reasons caregivers gave for not disclosing were that the child was too young and the potential psychosocial impacts on the child and the family. Using an education model of HIV disclosure, children's knowledge of HIV increased significantly, and ART adherence, which was good at 95%, increased to 99% an average of 9 months after education. CONCLUSION: There is a low rate of disclosure for HIV-infected children in Papua New Guinea. This study underlines the importance and value of incorporating age-appropriate HIV education within HIV services.
AIM: How to provide human immunodeficiency virus (HIV) disclosure and awareness for children and young people has not been studied in Papua New Guinea or Pacific Island countries. We aimed to determine the current practices of HIV disclosure and evaluate whether an incremental disclosure education model, as recommended by World Health Organization (WHO), would increase children's knowledge about their condition and improve adherence to antiretroviral therapy (ART). METHODS: We enrolled HIV-infectedchildren on ART whose parents consented, and we identified whether they were aware that they were HIV positive or not. An incremental education model was used to teach the children about their illness and to disclose their HIV status if that was the parents' wishes. Knowledge of HIV and adherence to ART before and following education sessions was assessed. RESULTS: A total of 138 childrenHIV-positive children were recruited. Only 7% had previously been made aware of their HIV test results; the mean disclosure age was 12.7 years. By 10 years of age, 25 of 34 participants (74%) had not been told they had HIV. The common reasons caregivers gave for not disclosing were that the child was too young and the potential psychosocial impacts on the child and the family. Using an education model of HIV disclosure, children's knowledge of HIV increased significantly, and ART adherence, which was good at 95%, increased to 99% an average of 9 months after education. CONCLUSION: There is a low rate of disclosure for HIV-infectedchildren in Papua New Guinea. This study underlines the importance and value of incorporating age-appropriate HIV education within HIV services.
Authors: Elijah Paintsil; Tassos C Kyriakides; Sampson Antwi; Lorna Renner; Justin S Nichols; Kofi Amissah; Jonas T Kusah; Amina Alhassan; Irene P Ofori; Ann C Catlin; Geliang Gan; Margaret Lartey; Nancy R Reynolds Journal: J Acquir Immune Defic Syndr Date: 2020-05-01 Impact factor: 3.771