HIV knowledge, stigma, and illness beliefs among pediatric caregivers in Ghana who have not disclosed their child's HIV status.
HIV knowledge, stigma, and illness beliefs among pediatric caregivers in Ghana who have not disclosed their child's HIV status.
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DOI：
10.1080/09540121.2015.1007116
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发表时间：
2015
期刊：
影响因子：
1.7
通讯作者：
Reynolds NR
中科院分区：
文献类型：
--
作者：
Paintsil E;Renner L;Antwi S;Dame J;Enimil A;Ofori-Atta A;Alhassan A;Ofori IP;Cong X;Kyriakides T;Reynolds NR
撒哈拉以南非洲地区大多数感染艾滋病毒的儿童尚未被告知其艾滋病毒状况。照顾者不愿向子女透露艾滋病毒状况，因为担心子女的理解能力、父母的内疚感以及害怕社会排斥和孤立。我们假设，加纳儿童艾滋病毒披露的低流行率是由于缺乏准确的艾滋病毒信息和照顾者之间的艾滋病毒高耻辱。这是对加纳艾滋病毒儿科披露干预研究（“Sankofa”）基线数据的初步分析。“Sankofa”是一项双臂随机对照临床试验，比较了Korle-Bu教学医院（KBTH;对照组）和Komfo-Anokye教学医院（KATH;干预组）的披露干预加常规护理（干预组）与常规护理（对照组）。我们招募了7-18岁的艾滋病毒感染儿童，他们不知道自己的艾滋病毒状况，以及他们的照顾者。基线资料包括人口学特征、简明艾滋病知识问卷（HIV-KQ-18）、简明疾病认知问卷和艾滋病污名量表。简单和多变量线性回归分析被用来评估照顾者的特点和艾滋病毒知识，耻辱和疾病的看法之间的关系。2013年1月至2014年7月期间，在两个研究中心招募了298名护理人员; KBTH（n = 167）和KATH（n = 131）。照顾者的中位年龄为41岁;其中80.5%为女性，约60%的照顾者为艾滋病毒阳性。78%的照顾者是自营职业者，家庭收入低。在未经调整和调整的分析中，HIV阴性状态和较低的教育水平与HIV-KQ的不良评分相关。在调整后的分析中，艾滋病毒阳性状态对更高水平的耻辱感仍然很重要。照顾者的特征没有预测照顾者的疾病感知。需要加强学校的艾滋病毒教育和有针对性的社区运动。
The majority of HIV-infected children in sub-Saharan Africa have not been informed of their HIV status. Caregivers are reluctant to disclose HIV status to their children because of concern about the child’s ability to understand, parental sense of guilt, and fear of social rejection and isolation. We hypothesized that the low prevalence of pediatric HIV disclosure in Ghana is due to lack of accurate HIV information and high HIV stigma among caregivers. This is a preliminary analysis of baseline data of an HIV pediatric disclosure intervention study in Ghana (“Sankofa”). “Sankofa” – is a two-arm randomized controlled clinical trial comparing disclosure intervention plus usual care (intervention arm) vs usual care (control arm) at Korle-Bu Teaching Hospital (KBTH; control arm) and Komfo-Anokye Teaching Hospital (KATH; intervention arm). We enrolled HIV-infected children, ages 7–18 years who do not know their HIV status, and their caregivers. Baseline data of caregivers included demographic characteristics; Brief HIV Knowledge Questionnaire (HIV-KQ-18); Brief Illness Perception Questionnaire; and HIV Stigma Scale. Simple and multivariable linear regression analyses were used to assess the relationship between caregiver characteristics and HIV knowledge, stigma, and illness perception. Two hundred and ninety-eight caregivers were enrolled between January 2013 and July 2014 at the two study sites; KBTH (n = 167) and KATH (n = 131). The median age of caregivers was 41 years; 80.5% of them were female and about 60% of caregivers were HIV-positive. Seventy-eight percent of caregivers were self-employed with low household income. In both unadjusted and adjusted analyses, HIV negative status and lower level of education were associated with poor scores on HIV-KQ. HIV positive status remained significant for higher level of stigma in the adjusted analyses. None of the caregiver’s characteristics predicted caregiver’s illness perception. Intensification of HIV education in schools and targeted community campaigns are needed.