Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo
HIV status disclosure to children remains a challenge in sub-Saharan Africa. For sociocultural reasons, parents often delay disclosure with subsequent risks to treatment compliance and the child’s psychological well-being. This article assesses the effects of HIV disclosure on second-line ART compli...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/12/1955 |
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| author | Faustin Nd. Kitetele Gilbert M. Lelo Cathy E. Akele Patricia V. M. Lelo Loukia Aketi Eric M. Mafuta Thorkild Tylleskär Espérance Kashala-Abotnes |
| author_facet | Faustin Nd. Kitetele Gilbert M. Lelo Cathy E. Akele Patricia V. M. Lelo Loukia Aketi Eric M. Mafuta Thorkild Tylleskär Espérance Kashala-Abotnes |
| author_sort | Faustin Nd. Kitetele |
| collection | DOAJ |
| description | HIV status disclosure to children remains a challenge in sub-Saharan Africa. For sociocultural reasons, parents often delay disclosure with subsequent risks to treatment compliance and the child’s psychological well-being. This article assesses the effects of HIV disclosure on second-line ART compliance after first-line failure. We conducted a retrospective study of 52 HIV-positive children at Kalembelembe Pediatric Hospital in Kinshasa who were unaware of their HIV status and had failed to respond to the first-line ART. Before starting second-line ART, some parents agreed to disclosure. All children were followed before and during the second-line ART. Conventional usual descriptive statistics were used. For analysis, the children were divided into two groups: disclosed to (<i>n</i> = 39) and not disclosed to (<i>n</i> = 13). Before starting the second-line ART, there was no difference in CD4 count between the two groups (<i>p</i> = 0.28). At the end of the first year of second-line ART, the difference was statistically significant between the two groups with regard to CD4% (<i>p</i> < 0.001) and deaths (<i>p</i> = 0.001). The children disclosed to also reported fewer depressive symptoms post-disclosure and had three times fewer clinic visits. HIV status disclosure to children is an important determinant of ART compliance and a child’s psychological well-being. |
| first_indexed | 2024-03-09T17:11:32Z |
| format | Article |
| id | doaj.art-7c7868a6ca024ed99126b35313c9fed3 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T17:11:32Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-7c7868a6ca024ed99126b35313c9fed32023-11-24T14:02:36ZengMDPI AGChildren2227-90672022-12-01912195510.3390/children9121955Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR CongoFaustin Nd. Kitetele0Gilbert M. Lelo1Cathy E. Akele2Patricia V. M. Lelo3Loukia Aketi4Eric M. Mafuta5Thorkild Tylleskär6Espérance Kashala-Abotnes7Department of Infectious Diseases, Kalembelembe Pediatric Hospital, Kinshasa 012, Democratic Republic of the CongoCentre Neuro-Psycho-Pathologique de Kinshasa (CNPP), Faculty of Medicine, University of Kinshasa, Kinshasa 012, Democratic Republic of the CongoDepartment of Infectious Diseases, Kalembelembe Pediatric Hospital, Kinshasa 012, Democratic Republic of the CongoDepartment of Infectious Diseases, Kalembelembe Pediatric Hospital, Kinshasa 012, Democratic Republic of the CongoPediatric Department, Faculty of Medicine, University of Kinshasa, Kinshasa 012, Democratic Republic of the CongoKinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa 012, Democratic Republic of the CongoCentre for International Health (CIH), Faculty of Medicine, University of Bergen, 5020 Bergen, NorwayCentre for International Health (CIH), Faculty of Medicine, University of Bergen, 5020 Bergen, NorwayHIV status disclosure to children remains a challenge in sub-Saharan Africa. For sociocultural reasons, parents often delay disclosure with subsequent risks to treatment compliance and the child’s psychological well-being. This article assesses the effects of HIV disclosure on second-line ART compliance after first-line failure. We conducted a retrospective study of 52 HIV-positive children at Kalembelembe Pediatric Hospital in Kinshasa who were unaware of their HIV status and had failed to respond to the first-line ART. Before starting second-line ART, some parents agreed to disclosure. All children were followed before and during the second-line ART. Conventional usual descriptive statistics were used. For analysis, the children were divided into two groups: disclosed to (<i>n</i> = 39) and not disclosed to (<i>n</i> = 13). Before starting the second-line ART, there was no difference in CD4 count between the two groups (<i>p</i> = 0.28). At the end of the first year of second-line ART, the difference was statistically significant between the two groups with regard to CD4% (<i>p</i> < 0.001) and deaths (<i>p</i> = 0.001). The children disclosed to also reported fewer depressive symptoms post-disclosure and had three times fewer clinic visits. HIV status disclosure to children is an important determinant of ART compliance and a child’s psychological well-being.https://www.mdpi.com/2227-9067/9/12/1955HIVantiretroviral therapy failurepediatricsdepressiondisclosurecompliance |
| spellingShingle | Faustin Nd. Kitetele Gilbert M. Lelo Cathy E. Akele Patricia V. M. Lelo Loukia Aketi Eric M. Mafuta Thorkild Tylleskär Espérance Kashala-Abotnes Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo Children HIV antiretroviral therapy failure pediatrics depression disclosure compliance |
| title | Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo |
| title_full | Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo |
| title_fullStr | Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo |
| title_full_unstemmed | Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo |
| title_short | Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo |
| title_sort | lessons learned from the impact of hiv status disclosure to children after first line antiretroviral treatment failure in kinshasa dr congo |
| topic | HIV antiretroviral therapy failure pediatrics depression disclosure compliance |
| url | https://www.mdpi.com/2227-9067/9/12/1955 |
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