Assessment of disclosure process of HIV status of the infected children and adolescents in selected health center in Rwanda

Abstract

Introduction: With Accessibility of antiretroviral drugs HIV infected children and adolescents live longer. HIV diagnosis disclosure is progressively more important and usual concern. Problem Statement: Disclosure of HIV status to children and adolescents is crucial for treatment adherence and it improves health status. In different countries including Rwanda the prevalence of disclosure of HIV status to infected children has been found to be low. Despite, proved effect of disclosure, a big number (36%) of caregivers don’t disclose HIV status to their children in Rwanda. The aim of the study: To assess the process of HIV status disclosure to infected children and adolescents in Kigali city. Significance of the study: When HIV positive status is disclosed to children, it helps them to regulate, contribute in decision-making in their treatment opportunity considering their age in, and access and receive suitable support. Furthermore, appropriate HIV status disclosure may improve social functioning and school performance by the children and adolescents. Research Methodology: Descriptive cross sectional design using a quantitative approach was used. The study was done in selected health center in Kigali city. The target population was healthcare providers working in ARV services, caregivers of infected children and adolescents and those infected children and adolescents. A simple random sampling method was used to select four health center from each district from Kigali city and a census method was used for study participants. A validated and reliable questionnaire was adopted and used. Data analysis was done using both descriptive and inferential statistics. Results: Of the 103 caregivers, 77 (70.6%) had disclosed the HIV status to their children. Among 109 children and adolescent with HIV status, 60 (77.9%) continued to take medications as usual after disclosure. In multivariate analysis, no variable was statistically associated with adherence to treatment. Lack of formal guideline and training on HIV disclosure were identified as barriers for healthcare workers during this process. For caregivers, non-disclosure process was mostly associated with stigma and lack of support from healthcare worker. Conclusion: Lack of formal guideline and training on HIV disclosure, as well as lack of support from healthcare worker, were reported, further research in this domain, will be of interest.