The prevalence and process of pediatric HIV disclosure: A population-based prospective cohort study in Zimbabwe
The prevalence and process of pediatric HIV disclosure: A population-based prospective cohort study in Zimbabwe
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DOI：
10.1371/journal.pone.0215659
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发表时间：
2019-05-22
期刊：
影响因子：
3.7
通讯作者：
Green, Eric P.
中科院分区：
文献类型：
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作者：
Finnegan, Amy;Langhaug, Lisa;Green, Eric P.
本研究的目的是评估津巴布韦农村地区儿童HIV信息披露的流行率，并跟踪信息披露的过程。方法我们招募了372名9至15岁HIV阳性儿童照顾者的人口样本，参与了一项关于信息披露的调查。使用这个横断面样本的数据，我们确定了123名护理人员的预期队列，他们说他们的艾滋病毒阳性孩子不知道他或她的艾滋病毒状况，我们跟踪了这名未披露的护理人员在接下来的12个月里进行了两次额外的数据收集。结果横断面样本中HIV披露的总发生率为66.9%(95%可信区间为62.0~71.5%)。只有26.9%的儿童知道他们是如何感染的，并知道他们可以将病毒传播给其他人(即“完全披露”)。年龄较大的孩子更有可能知道自己的状况。在基线未披露的照顾者中，近60%的儿童在12个月的研究期间了解了他们的艾滋病毒状况，但只有17.1%的儿童了解到他们是如何感染的，他们可以将病毒传播给其他人。大多数照顾者对他们孩子的吐露经历感到满意。没有向孩子透露孩子艾滋病毒状况的照顾者担心，披露信息会导致社区的耻辱，引发他们无法回答的孩子的问题，或者导致孩子愤怒地拒绝照顾者。结论这项研究表明，儿科艾滋病毒披露率可能比通常报告的要高，但也强化了这样一种观点，即大多数儿童不知道关于他们疾病的关键细节，例如他们是如何感染的，以及他们可能会感染其他人。
IntroductionThe objective of this study was to estimate the prevalence of pediatric HIV disclosure in rural Zimbabwe and track the process of disclosure over time.MethodsWe recruited a population-based sample of 372 caregivers of HIV-positive children ages 9 to 15 to participate in a survey about disclosure. Using data from this cross-sectional sample, we then identified a prospective cohort of 123 caregivers who said their HIV-positive child did not know his or her HIV status, and we followed this non-disclosed cohort of caregivers through two additional waves of data collection over the next 12 months. At each wave, we inquired about the timing and process of disclosure and psychosocial factors related to HIV disclosure.ResultsThe overall prevalence of disclosure in the cross-sectional sample was 66.9% (95% CI 62.0 to 71.5%). Only 26.9% of children knew how they were infected and that they can transmit the virus to others (i.e. "full disclosure"). Older children were more likely to know their status. Among the non-disclosed caregivers at baseline, nearly 60% of these children learned their HIV status over the course of the 12-month study period, but only 17.1% learned how they were infected and that they can transmit the virus to others. Most caregivers were satisfied with their child's disclosure experience. Caregivers who had not disclosed their child's HIV status to the child worried that disclosure would lead to stigma in the community, provoke questions from their child they would not be able to answer, or cause the child to reject the caregiver in anger.ConclusionsThis study suggests that rates of pediatric HIV disclosure may be larger than typically reported, but also reinforces the idea that most children do not know key details about their illness, such as how they were infected and that they can infect others.