Caregiver disclosure of HIV status and its influence on paediatric ART Adherence at Moi Teaching and Referral Hospital, Uasin Gishu County, Kenya

https://doi.org/10.51867/ajernet.6.2.43

Authors

  • Daniel Korir Masinde Muliro University of Science and Technology, Kenya
  • Victor Dinda Department of Medical Laboratory Sciences, Masinde Muliro University of Science & Technology, Kenya https://orcid.org/0009-0002-5667-0057
  • Salome Akinyi Achola Moi Teaching and Referral Hospital (MTRH) - AMPATH (Academic Model Providing Access to Healthcare)

Keywords:

Caregivers, HIV Disclosure, HIV Status, MTRH, Paediatric ART Adherence, Uasin Gishu County, Kenya

Abstract

Human Immunodeficiency Virus (HIV) remains a significant public health concern, particularly among children living with the virus. Disclosure of HIV status to infected paediatrics is a critical aspect of care, with potential consequences for treatment adherence, psychological well-being, and long-term health outcomes. Despite worldwide guidelines encouraging age-appropriate disclosure, many caregivers and healthcare providers remain hesitant, resulting in varied disclosure practices. This study aimed to assess the prevailing practices and rates of HIV status disclosure to children and examine how disclosure influences adherence to antiretroviral therapy (ART) among paediatric patients at Moi Teaching and Referral Hospital. The study employed a descriptive survey design guided by Social Cognitive Theory. The target population included 85 children living with HIV, 50 caregivers, and 70 healthcare providers. A census approach was used due to the manageable sample size. Data collection involved structured questionnaires, and analysis was performed using the Statistical Package for Social Sciences (SPSS), generating descriptive statistics including frequencies and percentages. Findings indicated that while some caregivers and providers had embraced disclosure, overall rates of full HIV status disclosure to children remained low. Many caregivers cited fear of psychological harm, stigma, and lack of disclosure training as major barriers. Importantly, children who were aware of their HIV status demonstrated significantly higher adherence to ART compared to those who were not informed. Awareness was also associated with improved understanding of treatment importance and better cooperation with care routines. The study concludes that HIV status disclosure positively influences ART adherence in children. However, persistent barriers hinder widespread implementation of disclosure practices. It is recommended that comprehensive caregiver and provider training programs be implemented, focusing on communication strategies, psychological support, and age-appropriate disclosure techniques. Additionally, post-disclosure support services such as counselling and peer support groups should be established to facilitate better health outcomes in HIV-positive children.

Dimensions

Amankwah-Poku, M., Klutsey, D. A., & Asante, K. O. (2021). Disclosure and health-related outcomes among children living with HIV and their caregivers. AIDS Research and Therapy, 18(1), 13. https://doi.org/10.1186/s12981-021-00337-z DOI: https://doi.org/10.1186/s12981-021-00337-z

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1-26. https://doi.org/10.1146/annurev.psych.52.1.1 DOI: https://doi.org/10.1146/annurev.psych.52.1.1

Beima-Sofie, K. M., Brandt, L., Hamunime, N., Shepard, M., Uusiku, J., John-Stewart, G. C., & O'Malley, G. (2017). Pediatric HIV disclosure intervention improves knowledge and clinical outcomes in HIV-infected children in Namibia. Journal of Acquired Immune Deficiency Syndromes, 75(1), 18-26. https://doi.org/10.1097/QAI.0000000000001290 DOI: https://doi.org/10.1097/QAI.0000000000001290

Beima-Sofie, K., Brandt, L., Hamunime, N., Shepard-Perry, M., Tuthill, E., & John-Stewart, G. C. (2014). Pediatric HIV disclosure intervention improves knowledge and clinical outcomes in HIV-infected children in Namibia. Journal of Acquired Immune Deficiency Syndromes, 66(2), 162-167. https://doi.org/10.1097/QAI.0000000000000156

Brown, B. J., Oladokun, R. E., Osinusi, K., Ochigbo, S., Adewole, I. F., & Kanki, P. (2011). Disclosure of HIV status to infected children in a Nigerian HIV care programme. AIDS Care, 23(9), 1053-1058. https://doi.org/10.1080/09540121.2011.554523 DOI: https://doi.org/10.1080/09540121.2011.554523

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.

Doat, A.-R., Negarandeh, R., & Hasanpour, M. (2019). Disclosure of HIV status to children in sub-Saharan Africa: A systematic review. Medicina, 55(8), 433. https://doi.org/10.3390/medicina5508043 DOI: https://doi.org/10.3390/medicina55080433

Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1-4. https://doi.org/10.11648/j.ajtas.20160501.11 DOI: https://doi.org/10.11648/j.ajtas.20160501.11

https://doi.org/10.11648/j.ajtas.20160501.11

Ferrand, R. A., Simms, V., Dauya, E., Bandason, T., McHugh, G., Mujuru, H., & Gibb, D. M. (2018). HIV care in children in sub-Saharan Africa: Improving adherence to ART and optimizing care strategies. The Lancet Child & Adolescent Health, 2(4), 2-9. https://doi.org/10.1016/S2352-4642(18)30058-8

Field, A. (2018). Discovering statistics using IBM SPSS Statistics (5th ed.). SAGE Publications.

Kalembo, F. W., Kendall, G. E., Ali, M., Chimwaza, F. A., & Tallon, M. M. (2020). Healthcare workers' perspectives on disclosure of HIV status to children in Malawi. International Journal of Africa Nursing Sciences, 13, 100247. https://doi.org/10.1016/j.ijans.2020.100247

Kimera, E., Vindevogel, S., Reynaert, D., Justice, K. M., Rubaihayo, J., & Bilsen, J. (2020). Experiences and effects of HIV status disclosure to children in Uganda: A qualitative study. BMC Public Health, 20(1), 1-10. DOI: https://doi.org/10.1186/s12889-020-8198-7

https://doi.org/10.1186/s12889-020-8198-7

Krauss, B. J., Letteney, S., & De Baets, A. J. (2013). Guiding the process of disclosure: Development of a disclosure support framework for children and adolescents infected with HIV. Social Work in Health Care, 52(4), 362-379. https://doi.org/10.1080/00981389.2012.737901

Lowenthal, E. D., Jibril, H. B., Sechele, M. L., Mathuba, K., Tshume, O., Anabwani, G. M., & Gross, R. (2014). Disclosure of HIV status to HIV-infected children in a large African treatment center: Lessons learned in Botswana. Children and Youth Services Review, 45, 143-149. https://doi.org/10.1016/j.childyouth.2014.03.031 DOI: https://doi.org/10.1016/j.childyouth.2014.03.031

Mellins, C. A., Brackis-Cott, E., Dolezal, C., & Abrams, E. J. (2002). The role of psychosocial and family factors in adherence to antiretroviral treatment in human immunodeficiency virus-infected children. The Pediatric Infectious Disease Journal, 21(11), 1035-1041. https://doi.org/10.1097/01.inf.0000143646.15240.ac DOI: https://doi.org/10.1097/01.inf.0000143646.15240.ac

Molato, B. J., Moloko-Phiri, S. S., Koen, M. P., & Matsipane, M. J. (2021). Telling children with perinatal HIV about their HIV serostatus: Healthcare workers' practices and barriers to disclosing in a South African rural health district. Journal of Primary Care & Community Health, 12, 2150132720984757. https://doi.org/10.1177/2150132720984757 DOI: https://doi.org/10.1177/2150132720984757

MTRH. (2025). About us. https://www.mtrh.go.ke/?page_id=14

UNAIDS. (2020). Global AIDS Update (2020): Seizing the moment - tackling entrenched inequalities to end epidemics. Joint United Nations Programme on HIV/AIDS. https://www.unaids.org/en/resources/documents/2020/global-aids-report

Vreeman, R. C., Gramelspacher, A. M., Gisore, P. O., Scanlon, M. L., & Nyandiko, W. M. (2013). Disclosure of HIV status to children in resource-limited settings: A systematic review. Journal of the International AIDS Society, 16(1), 18466. https://doi.org/10.7448/IAS.16.1.18466 DOI: https://doi.org/10.7448/IAS.16.1.18466

Vreeman, R. C., Nyandiko, W. M., Ayaya, S. O., Walumbe, E. G., Marrero, D. G., & Inui, T. S. (2010). The perceived impact of disclosure of paediatric HIV status on paediatric antiretroviral therapy adherence, child well-being, and social relationships in a resource-limited setting. AIDS Patient Care and STDs, 28(2), 98-104. https://doi.org/10.1089/apc.2013.0284

WHO. (2011). Guideline on HIV disclosure counselling for children up to 12 years of age. https://www.who.int/publications/i/item/9789241502863

WHO. (2021). HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV: Recommendations for a public health approach and considerations for policy-makers and managers. https://www.who.int/publications/i/item/9789241506168

World Medical Association. (2013). WMA Declaration of Helsinki: Ethical principles for medical research involving human subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki

Published

2025-05-19

How to Cite

Korir, D., Dinda, V., & Achola, S. A. (2025). Caregiver disclosure of HIV status and its influence on paediatric ART Adherence at Moi Teaching and Referral Hospital, Uasin Gishu County, Kenya. African Journal of Empirical Research, 6(2), 522–530. https://doi.org/10.51867/ajernet.6.2.43