Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo

• Main Authors: Faustin Nd. Kitetele (Author), Gilbert M. Lelo (Author), Cathy E. Akele (Author), Patricia V. M. Lelo (Author), Loukia Aketi (Author), Eric M. Mafuta (Author), Thorkild Tylleskär (Author), Espérance Kashala-Abotnes (Author)
• Format: Book
• Published: MDPI AG, 2022-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

10.3390/children9121955
2227-9067