Disclosure of status among Human Immunodeficiency Virus-infected adolescents

Abstract

Background: Disclosing a positive Human Immunode ciency Virus (HIV)-infection status to a child pose major challenges to caregivers for various reasons. Objective: This study aims to determine the prevalence, pattern and effect of disclosure among HIV-infected adolescents attending a tertiary hospital in Nigeria. Materials and Methods: A cross-sectional study among adolescents attending the HIV Paediatric clinic at the University of Abuja Teaching Hospital, Gwagwalada. A questionnaire was administered after ethically age-appropriate consent and assent had been obtained from the adolescents or adolescent/caregiver pairs. Blood was also drawn for CD4 count and viral load assay. Results: One hundred and forty-five adolescents participated in the study. Eighty (55.2%) were males, 78(53.8%) aged 10-13 years while 91(62.7%) had secondary level of education. Fifty-nine (40.7%) adolescents had been disclosed to. The mean age of disclosure was 14.6±2.2. Disclosure was mostly by mothers (n = 32; 22.1%), at home (n = 43; 29.7%) and their status revealed by 14 (23.7%) of the adolescents to mainly their siblings (n = 10; 6.9%). At disclosure, 19 (13.1%) felt bad/sad while 18 (12.4%) were indifferent. The preferred age for disclosure was 14–16 years (n = 33; 22.8%). There was a statistically significant relationship between disclosure and; adolescents' age (P = <0.001), mean age of disclosure (P = <0.001); social class (P = 0.046); caregivers' educational level (P = < 0.01) and CD4 count (P = 0.003) but none for gender (P = 0.59), type of ARV medication (P = 0.519), self-reported adherence (P = 0.476) and viral load (P = 0.729). Conclusion: Disclosure prevalence was low. Caregivers should be better counseled and encouraged on the importance of early disclosure.