THE THORNY ISSUE OF STATUS DISCLOSURE TO CHILDREN LIVING WITH HIV: THE CASE OF HIV POSITIVE CHILDREN LIVING IN A CHILD AND YOUTH CARE FACILITY IN JOHANNESBURG, SOUTH AFRICA

There is a dilemma regarding HIV/AIDS disclosure to children born and living with HIV/AIDS in residential settings. Since the advent and accessibility of Anti-Retroviral Therapy, most children born HIV positive live longer and have healthier lives. Some of these children find themselves in Need of Care due to abandonment, orphanhood and neglect or abuse, and are placed in alternative care such as a Child and Youth Care Centre (CYCC). Social Service Workers are then faced with this dilemma around disclosure of their HIV status, due to the complexities around the consequences of such a disclosure, and the absence of clear policies in this regard. The study explored the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living in a CYCC in Ekurhuleni, South Africa. The findings indicate that HIV status disclosure is a complex but essential process as it reinforces children’s ability to adhere to medication and dispels anxiety and suspicion within themselves around their status. Recommendations relate to community education and awareness programmes, policy and practice changes and makes suggestions for future research.

Download Full-text

Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-043941 ◽

2021 ◽

Vol 11 (10) ◽

pp. e043941

Author(s):

Tafadzwa Dhokotera ◽

Julia Bohlius ◽

Matthias Egger ◽

Adrian Spoerri ◽

Jabulani Ronnie Ncayiyana ◽

...

Keyword(s):

South Africa ◽

Young Adults ◽

Cross Sectional Study ◽

Adolescents And Young Adults ◽

Hiv Positive ◽

Sectional Study ◽

Hiv Status ◽

Cross Sectional ◽

Laboratory Service ◽

Living With Hiv

ObjectiveTo determine the spectrum of cancers in adolescents and young adults (AYAs) living with and without HIV in South Africa.DesignCross-sectional study with cancer records provided by the National Cancer Registry (NCR) and HIV records from the National Health Laboratory Service (NHLS).Setting and participantsThe NHLS is the largest provider of pathology services in the South African public sector. The NCR is a division of the NHLS. We included AYAs (aged 10–24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8479). HIV status was obtained through record linkages and text mining.Primary and secondary outcomesWe determined the spectrum of cancers by HIV status in AYAs. We used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex, ethnicity and calendar period. We imputed (post hoc) the HIV status for AYA with unknown HIV status.Results8479 AYAs were diagnosed with cancer, HIV status was known for 45% (n=3812). Of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi’s sarcoma (adjusted OR (aOR) 218, 95% CI 89.9 to 530), cervical cancer (aOR 2.18, 95% CI 1.23 to 3.89), non-Hodgkin’s lymphoma (aOR 2.12, 95% CI 1.69 to 2.66) and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27 to 5.86) than AYAs without HIV. About 44% (n=1062) of AYAs with HIV-related cancers had not been tested for HIV.ConclusionsTargeted HIV testing for AYAs diagnosed with cancer, followed by immediate start of antiretroviral therapy, screening for cervical precancer and vaccination against human papilloma virus is needed to decrease cancer burden in AYAs living with HIV in South Africa.

Download Full-text

Disclosure Experiences and Challenges Among Children and Adolescents Living with HIV/AIDS in Nigeria-A Review of the Literature

International Journal of Health and Life Sciences ◽

10.5812/ijhls.110975 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Nzube Pauline Okolo-Francis ◽

Uyinonijesu Diamond Victor-Ogie ◽

Abdulmumin Ibrahim ◽

Amos Abimbola Oladunni ◽

Goodness Ogeyi Odey ◽

...

Keyword(s):

Children And Adolescents ◽

Healthcare Workers ◽

Negative Impact ◽

Hiv Positive ◽

Review Of The Literature ◽

Hiv Status ◽

Clinical Context ◽

The Mean ◽

Living With Hiv ◽

Status Disclosure

Context: Disclosure of HIV positive infection status in children and Adolescents is multifaceted and should take into consideration their age, psychosocial maturity, cultural and clinical context. This study was conducted to examine disclosure experiences and challenges among children and ALWHA in Nigeria. Evidence Acquisition: We conducted narrative review of relevant literatures by searching PubMed, Google scholar and Medscape using predetermined keywords. Results: Findings are presented under themes of process of disclosure and age of disclosure, reasons and challenges of disclosure, reactions and responses to disclosure, consistent with various authors. This study shows that the mean age and reasons for HIV positive status disclosure are variable. Disclosure was mostly executed at home and mostly carried out by parents or caregivers of HIV-infected children. Reactions of children and ALWHA upon disclosure was mainly negative and ranged from feeling of anger to expression of shock to feeling of sadness and to crying. Barriers to HIV-positive status disclosure among caregivers were perceived sense immaturity and age of the child, fear of stigma, fear of child’s inability to cope, fear of blaming the parents and refusal to take antiretroviral (ARV) drugs. While caregivers highlighted several factors that affect disclosure of HIV status to children and adolescents, this study reveals both positive and negative impact on their emotions. Conclusions: It is of note that approach to disclosure is critical, therefore caregivers and healthcare workers should be properly trained and supported with resources required to effectively carry out disclosure. There is need for continuous research to understand and develop age and culture specific approaches to disclosure in children and adolescents in Nigeria.

Download Full-text

Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

Systematic Reviews ◽

10.1186/s13643-020-01546-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Patience Adzordor ◽

Clement Avoka ◽

Vitalis Bawontuo ◽

Silas Agbesi ◽

Desmond Kuupiel

Keyword(s):

Hiv Infection ◽

Scoping Review ◽

Keyword Search ◽

Sub Saharan Africa ◽

Hiv Positive ◽

People Living With Hiv ◽

Sub Saharan ◽

Living With Hiv ◽

Status Disclosure ◽

Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

Download Full-text

Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

10.1101/2020.08.18.20176289 ◽

2020 ◽

Author(s):

Tafadzwa G Dhokotera ◽

Julia Bohlius ◽

Matthias Egger ◽

Adrian Spoerri ◽

Jabulani Ncayiyana ◽

...

Keyword(s):

South Africa ◽

Cervical Cancer ◽

Cross Sectional Study ◽

Hiv Positive ◽

Sectional Study ◽

Hiv Status ◽

Cross Sectional ◽

Cancer Data ◽

Living With Hiv ◽

Hiv Negative

Objective: To determine the spectrum of cancers in AYAs living with HIV in South Africa compared to their HIV negative peers. Design: Cross sectional study with cancer data provided by the National Cancer Registry and HIV data from the National Health Laboratory Service. Setting and participants: The NHLS is the largest provider of pathology services in the South African public sector with an estimated coverage of 80%. The NCR is a division of the NHLS. We included AYAs (aged 10-24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8 479). We included 3 672 in the complete case analysis. Primary and secondary outcomes: We used linked NCR and NHLS data to determine the spectrum of cancers by HIV status in AYAs. We also used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex (as appropriate), ethnicity, and calendar period. Due to the large proportion of unknown HIV status we also imputed (post-hoc) the missing HIV status. Results: From 2004-2014, 8 479 AYAs were diagnosed with cancer, HIV status was known for only 45% (n=3812); of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi's sarcoma (adjusted odds ratio (aOR) 218, 95% CI 89.9-530), cervical cancer (aOR 2.18, 95% CI 1.23-3.89), non-Hodgkin's lymphoma (aOR 2.12, 95% CI 1.69-2.66), and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27-5.86). About 44% (n=1 062) of AYAs with HIV related cancers had not been tested for HIV, though they were very likely to have the disease. Conclusions: Cancer burden in AYAs living with HIV in South Africa could be reduced by screening young women for cervical cancer and vaccinating them against human papilloma virus (HPV) infection.

Download Full-text

Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review

Women s Health ◽

10.1177/17455065211063021 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110630

Author(s):

Aklilu Endalamaw ◽

Yibeltal Assefa ◽

Demeke Geremew ◽

Habte Belete ◽

Berihun Assefa Dachew ◽

...

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Sexual Partners ◽

Hiv Positive ◽

People Living With Hiv ◽

Hiv Status ◽

Living With Hiv ◽

Status Disclosure ◽

The Impact

Introduction: In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV’s disclosure status to sexual partners. Methods: CRD42020149092 is the protocol’s registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger’s regression test, respectively. The I2 statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation. Results: The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner’s HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure. Conclusion: In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

Download Full-text

Reflections on the Church and HIV/AIDS

Theology Today ◽

10.1177/004057360506200104 ◽

2005 ◽

Vol 62 (1) ◽

pp. 29-37 ◽

Cited By ~ 6

Author(s):

Beverley Haddad

Keyword(s):

South Africa ◽

Church Leaders ◽

Contextual Theology ◽

Hiv Positive ◽

People Living With Hiv ◽

Aids Pandemic ◽

Living With Hiv ◽

The Church ◽

Care Support ◽

Hiv Aids

The church in South Africa faces a new challenge—the HIV/AIDS pandemic, which claims the lives of people in its communities and congregations every day. Until recently, the church remained silent or, worse still, adopted a theology that contributed to the stigma and discrimination faced by those who are HIV-positive. Increasingly, this theology is being questioned, as church leaders take a more positive public stance on education, prevention, care, support, and lobbying for treatment. Yet a mainstream, contextual theology that acknowledges and supports people living with HIV/AIDS, offering them Christian hope and acceptance, still remains to be formulated for South Africa.

Download Full-text

Pengetahuan Ibu HIV Mempengaruhi Perilaku Pencegahan Penularan HIV/AIDS dari Ibu ke Bayi di Provinsi Jawa Tengah

JURNAL PROMOSI KESEHATAN INDONESIA ◽

10.14710/jpki.12.2.238-250 ◽

2017 ◽

Vol 12 (2) ◽

pp. 238

Author(s):

Khoiriyah Isni ◽

Zahroh Shaluhiyah ◽

Kusyogo Cahyo

Keyword(s):

Hiv Positive ◽

Hiv Status ◽

Chi Square ◽

Cross Sectional ◽

Central Java ◽

Hiv Positive Mothers ◽

Living With Hiv ◽

Mother To Child ◽

Central Java Province ◽

Hiv Aids

ABSTRAKPMTCT merupakan program pemerintah untuk menekan terjadinya penularan HIV/AIDS ke bayi. Inti dari kegiatan PMTCT adalah strategi mencegah terjadinya penularan HIV/AIDS dari ibu ke bayi pada ibu hamil yang telah terinfeksi HIV. Namun masih terdapat ibu HIV yang terlambat mengetahui status HIV sehingga tidak ikut serta dalam PMTCT. Penelitian ini bertujuan mengetahui perilaku ibu HIV dalam upaya mencegah penularan HIV/AIDS dari ibu ke bayi. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross sectional. Pengambilan data dilakukan pada 32 ibu HIV yang memiliki balita di Provinsi Jawa Tengah. Analisis data menggunakan analisis univariat dengan distribusi frekuensi, bivariat menggunakan Chi-Square dan Fisher Exact, dan multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa faktor yang berhubungan dengan perilaku ibu HIV dalam pencegahan penularan HIV/AIDS dari ibu ke bayi adalah usia bayi, waktu diketahui status HIV, waktu mulai mengikuti ARV, keikutsertaan PMTCT, waktu mulai mengikuti PMTCT, dan pengetahuan. Sedangkan faktor yang paling dominan terhadap perilaku ibu HIV dalam pencegahan penularan HIV/AIDS dari ibu ke bayi adalah pengetahuan. Dari penelitian ini, maka dapat disimpulkan bahwa pengetahuan dapat mempengaruhi perilaku ibu HIV dalam pencegahan penularan HIV/AIDS dari ibu ke bayi.Kata kunci : Ibu HIV, Pencegahan Penularan HIV/ADS dari ibu ke bayi, Provinsi Jawa TengahABSTRACTBehavior of HIV-Positive Mothers in Prevention Mother to Child Transmission of HIV/AIDS in Central Java ProvincePMTCT was government program to suppres HIV/AIDS and child. The point of PMTCT activities was a strategy to prevent HIV/AIDS transmission from mothers living with HIV/AIDS to their child. However, there were mothers living with HIV/AIDS who have been too late knowing their status HIV status so that they did not join PMTCT. This study aims to learn about HIV-positive mothers behavior in preventing of HIV/AIDS transmission from mother to child. This research was a quantitative with cross sectional approach. The data was collected from 32 mothers living with HIV/AIDS who had toddler babies in Central Java Province. Data were analyzed using univariate with frequency distribution, bivariate with chi square and fisher exact, and multivariate with logistic regression. The result showed that the variable which correlated towards behavior of HIV-positive mothers in preventing HIV/AIDS transmission from mother to child were age of child, HIV status reveal time, time of joining ARV, joining PMTCT, time of joining PMTCT, and knowledge. While, knowledge was the main variable that has considerable influence on the behavior of HIV-positive mothers. From this research, can be conclude that knowledge can affect HIV-positive mother’s behavior.Keywords: HIV-positive mothers, PMTCT, Central Java Province

Download Full-text

HIV Disclosure and Quality of Life in People Living with HIV/AIDS in Yogyakarta

Indonesian Journal of Nursing Practices ◽

10.18196/ijnp.v4i2.6989 ◽

2020 ◽

Vol 4 (2) ◽

pp. 50-58

Author(s):

Tutur Irfantoro ◽

Dwi Kartika Rukmi

Keyword(s):

Quality Of Life ◽

Hiv Disclosure ◽

People Living With Hiv ◽

Hiv Status ◽

Cross Sectional ◽

Hiv Status Disclosure ◽

Living With Hiv ◽

Status Disclosure ◽

Hiv Aids

Background: Victory Plus Foundation is a Non-Government Organization that helps the population directly affected by HIV/AIDS in Yogyakarta. Status disclosure’s research on People Living with HIV/AIDS (PLWHA) in Victory Plus Foundation is scarce. Even though the status disclosure is one of HIV spreading prevention, it has two-sided effects, both negative and positive, so its result can affect the quality of life despite PLWHA having tried to find a support system. Therefore, it is essential to know how the quality of life of PLWHA has opened up their status.Purpose: This study aimed to determine the relationship between HIV status disclosure and the quality of life of PLWHA in the Victory Plus Foundation, Yogyakarta.Method: This descriptive-analytic correlation study with a cross-sectional approach was conducted in June-July 2019 on 68 PLWHA at the Victory Plus Foundation. Purposively, samples were asked to fill out a disclosure questionnaire and WHOQOL-BREF. Univariate data presented in descriptions and Chi-Square tested bivariate data.Result: Most of the HIV status disclosure of PLWHA in the Victory Plus foundation was classified into a moderate category (77.9%) and low quality of life (64 %). The bivariate test result found a significant relationship between the HIV status disclosures with the quality of life in general (p = 0.001) with a moderate relationship closeness (r=0.403).Conclusion: Consequently, there is a relationship between the HIV status disclosures with the quality of life of PLWHA in the Victory Plus Foundation in Yogyakarta.

Download Full-text

PROSES DISCLOSURE DAN KONDISI PSIKOSOSIAL ANAK DENGAN HIV/AIDS

Jurnal Ilmu Kesejahteraan Sosial ◽

10.7454/jurnalkessos.v17i2.112 ◽

2016 ◽

Vol 17 (2) ◽

Author(s):

Arini Dwi Deswanti ◽

Johanna Debora Imelda

Keyword(s):

Group Discussion ◽

Hiv Status ◽

Psychosocial Condition ◽

Psychosocial Conditions ◽

Delayed Disclosure ◽

Hiv Status Disclosure ◽

Living With Hiv ◽

Status Disclosure ◽

Hiv Aids

<br /><table class="data" width="100%"><tbody><tr valign="top"><td class="value"><p>HIV-infected children have a longer life expectancy after the invention of antiretroviral treatment. Therefore, a well-prepared HIV status disclosure become a significant issue for children living with HIV/AIDS (CLWHA). Previous studies have shown that disclosing a status of children with chronic illness helps them to cope with the illness. However, delayed disclosure for various reasons which often influenced by parents or caregivers consideration affect children’s psychosocial condition. This paper will illustrate the psychosocial condition of CLWHA in relation to the preparation of their disclosure process.This descriptive study used a qualitative approach with observations, indepth interviews, and Focus Group Discussion on CLWHA and their parents/caregivers.Not all disclosed CLWHA has a good psychosocial function. The disclosure are affected by the process and the disclosure level. A HIV disclosed child of HIV positive parents has better psychosocial conditions than a child whose disclose are prepared by a pediatrician or than those who partially disclosed by themselves.Disclosing HIV/AIDS status has significantly affected the psychosocial condition of CLWHA. Therefore, it needs to be carefully well planned and well prepared by taking into account the condition of ADHAs and their caregivers to avoid involuntary disclosure.The government needs to formulate policies on disclosure process for CLWHA to maintain the psychosocial condition of the children so that their quality of life can be better increased.</p></td></tr></tbody></table>

Download Full-text

Human Immunodeficiency Virus Positive status disclosure to a sexual partner and its determinant factors in Ethiopia. A systematic review and meta-analysis.

10.21203/rs.3.rs-16527/v2 ◽

2020 ◽

Author(s):

Fikadu Ambaw Yehualashet ◽

Eleni Tesfaye Tegegne ◽

Mekbib Kassa Tessema ◽

Mulualem Endeshaw

Keyword(s):

Systematic Review ◽

Human Immunodeficiency Virus ◽

Meta Analysis ◽

Hiv Positive ◽

Hiv Status ◽

Pooled Prevalence ◽

Immunodeficiency Virus ◽

Regression Test ◽

Status Disclosure ◽

Hiv Aids

Abstract Background: Disclosure of Human Immunodeficiency Virus positive status significantly reduced the transmission of HIV; yet, it remains a challenge for many HIV patients. Disclosure serves plays a crucial role to raise awareness and to reduce risky behaviors. Hence, this study aimed to determine the pooled prevalence and effect sizes of determinant factors of HIV positive status disclosure through a systematic review and meta-analysis of the results of the existing primary studies in Ethiopia. Method: This systematic review and meta-analysis was aimed to determine prevalence of HIV positive status disclosure and associated factors by considering and searching published primary articles from different sources. A sensitivity test was conducted to evaluate the presence of influential studies. Besides, the heterogeneity test has been conducted; and publication bias was examined through observing the funnel plot as well as objectively by interpreting the Egger’s regression test. Following the Egger’s regression test, P-value <0.05 was considered as statistically significant at 95% Confidence Interval. Result: A total of 18 primary studies were searched from different data sources. The overall pooled prevalence of HIV positive status disclosure among adult PLWHA in Ethiopia was indicated to be 75.95% (95% CI:69.93-81.98); the highest and lowest pooled estimated HIV status disclosure was in Amhara (82.78%) and Tigray (54.31%) regions respectively. Furthermore, Knowing the HIV positive status of sexual partner, AOR=19.66(95% CI: 10.19-37.91), having prior discussion about HIV testing with their partner, AOR=9.18(95% CI: 5.53-15.24), got Human Immunodeficiency Virus pretest counseling service AOR=4.29(95% CI: 2.56-7.21) and being a member of HIV/AIDS associations, AOR=3.34(95% CI: 2.17-5.12), were significantly associated with HIV positive status disclosure among People living With HIV/AIDS in Ethiopia.Conclusion: The pooled national estimate of HIV/AIDS positive status disclosure is low as compared to the WHO disclosure rate of developing countries and the findings of other national and international studies. Ministry of health and other stakeholders shall design new approaches and strategies to encourage disclosure of HIV status, educate the public about the negative impact of nondisclosure within family members. Health care providers working at Human HIV test centers shall emphasis extensive counseling on disclosure of status to a partner. Moreover, different stakeholders, health workers and community members shall establish, organize, and support HIV/AIDS Associations and motivate HIV positive people to be engaged and participated.

Download Full-text