Magnitude and barriers of parents and caregivers disclosure of HIV positive status to their HIV infected children in Kinondoni Municipality Dar es salaam Tanzania.
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Date
2018
Authors
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Journal ISSN
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Publisher
Hubert Kairuki Memorial University
Abstract
Background – Since most of pediatric HIV occur prenatal it is certain that the infected children are unaware of their HIV status . The introduction and expansion of antiretroviral drugs has led to HIV infected children to survive into adolescence and adulthood. Thus disclosure of HIV diagnosis is becoming important and un avoidable issue for long term management. There are many challenges that parents and caregivers face when they intend to disclose the HIV positive status to their HIV infected children. Objective- To find out the prevalence and barriers in disclosure of HIV positive status to HIV infected children attending at Mwananyamala CTC in Kinondoni Municipality in Dar es salaam Tanzania. Methodology- – A cross sectional Hospital based study was done from December 2017 to may 2018 at Mwananyamala regional Hospital in Kinondoni . Participants were parents and care givers of HIV infected children and their children aged between 4 to 15 years. Random sampling technique was used to select participant for inclusion into the study from parents/caregivers and their children who were waiting for consultation on routine monthly visits at CTC. Sample size was determined using Khthari formula. Data was entered and analyzed by Ep info version 7. Logistic regression was done to obtain association characteristics. Results – A total of 214 parents/caregiver and 235 HIV infected children were enrolled in the study. The median age for children was 11 years with respective ranges between 4 to 15. The number of children fully disclosed of their HIV status at the time of enrollment was 44.3% (n =104). The majority of them (62.5%) were aged between 11 and 15 years. Parent/caregivers gave various reasons as to why they did not disclose HIV status to their infected children . Of the 214 parents/caregivers interviewed, 139 (65%) said children could not hide secret while 123 (57%) said children were not mature enough . Other reasons for non disclosure given by 12 (5.6%) children was Lack of Skills and 26 (12.2%) fear of psychological harm and emotional distress. Conclusion– This study revealed that the prevalence of disclosure of HIV status to HIV infected children was 44.3% (104) while Ideally it should be 100%. This is due to parents/caregiver barrier s to disclose their HIV infected children. The prevalence of disclosure in this study is relatively higher compared to other studies conducted in Tanzania and other developing countries. The study found out that disclosure of HIV positive status by parents and caregivers was not done in line with Tanzanian HIV Guidelines nor with WHO Disclosure guidelines (61.6%) and (46.2%) respectively . Main barrier of disclosure was fear of stigma and discrimination, since parents believed that their children were too young and could not keep secret of HIV positivity. Once people know of about the HIV status they will stigmatize and discriminate the Family members. Recommendation – More efforts are required to empower parents and caregivers to be able to undertake disclosure of HIV positive status to their infected children in collaboration with health workers at Mwananyamala and other care and other CTC throughout the country. It is emphasized that HIV children testing and counseling should begin from early period of infancy, childhood and adolescents as spelt out in the Tanzania Guidelines. It Is important that disclosure of HIV status to infected children should abide with the existing Tanzanian and WHO disclosure guidelines.
Description
A dissertation submitted in partial fulfillment of the requirement for the degree of master of medicine (Pediatrics) of Hubert Kairuki Memorial University.
Keywords
Pediatric HIV, Parent, Caregivers
Citation
Mwapinga, Kaninsia J., 2018. Magnitude and barriers of parents and caregivers disclosure of HIV positive status to their HIV infected children in Kinondoni Municipality Dar es salaam Tanzania. HKMU.