Prevalence and Factors Associated With Disclosure of HIV Diagnosis To Infected Children Receiving Antiretroviral Treatment in Public Health Care Facilities in Gauteng, South Africa - Prevalence and Factors Associated With Disclosure of HIV Diagnosis To Infected Children Receiving Antiretroviral Treatment in Public Health Care Facilities in Gauteng, South Africa - Open Access Pub

HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4–17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child’s age older than 10 years (OR =1.63; 95% CI: 1.44–1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47–0.87), and caregiver’s age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities. DOI10.14302/issn.2324-7339.jcrhap-12-74 In the past six years, South Africa has established the largest paediatric antiretroviral programme in the world, with an estimated coverage of 81% of children in need of antiretroviral therapy (ART) by the end of 2009 1. The increased access to ART in South Africa resulted in an increase in the survival time of adults and children living with HIV 2. With increased access to ART, HIV infected children are surviving to older ages, and disclosure has become an essential part of their comprehensive medical care 3. However, data from studies conducted in developing countries show that many HIV infected children on ART do not know their HIV diagnosis 4, 5, 6, 7, 8, 9. Furthermore, available data on HIV disclosure to infected children from studies conducted in developed and developing countries do not explain the low disclosure rates 10, 11, 12. Literature further shows that, most studies on the