ArticleAIDS patient care and STDs2014
Using health provider insights to inform pediatric HIV disclosure: a qualitative study and practice framework from Kenya.
Article in AIDS patient care and STDs, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 44 citations in OpenAlex.
- Factors associated with caregiver compliance to an HIV disclosure intervention and its effect on HIV and mental health outcomes among children living with HIV:Frontiers in public health · 2023Trial
- Clinic-Based Pediatric Disclosure Intervention Trial Improves Pediatric HIV Status Disclosure in Ghana.Journal of acquired immune deficiency syndromes (1999) · 2020Trial
- Article
- HIV Cure Research: Ethical and Real-World Practical Considerations for Pediatric and Adolescent Populations.Journal of the Pediatric Infectious Diseases Society · 2026Article
- Article
- "The Peer Educator Is the Game-Changer of My Life": Perceptions of Adolescents Living with HIV in DR Congo on Involving Peer Educators in the Process of HIV Disclosure.Children (Basel, Switzerland) · 2022Article
- Experiences of South African caregivers disclosing to their children living with HIV: Qualitative investigations.PloS one · 2022Article
- 24-Month Clinical, Immuno-Virological Outcomes, and HIV Status Disclosure in Adolescents Living With Perinatally-Acquired HIV in the IeDEA-COHADO Cohort in Togo and Côte d'Ivoire, 2015-2017.Frontiers in pediatrics · 2021Article
- Truth, Deception, and Coercion; Communication Strategies Used by Caregivers of Children with Perinatally Acquired HIV During the Pre-Disclosure and Post-Disclosure Period in Rural Communities in South Africa.Global pediatric health · 2021Article
- The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study.Children (Basel, Switzerland) · 2020Article
- Article
- Pain, Anger, and the Fear of Being Discovered Persist Long after the Disclosure of HIV Serostatus among Adolescents with Perinatal HIV in Rural Communities in South Africa.Children (Basel, Switzerland) · 2020Article
- Disclosure and Clinical Outcomes Among Young Adolescents Living With HIV in Kenya.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2019Article
- Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa.AIDS research and treatment · 2019Review
- Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers: a pilot study.African journal of AIDS research : AJAR · 2018Article
- Article
- Healthcare workers' perspectives and practices regarding the disclosure of HIV status to children in Malawi: a cross-sectional study.BMC health services research · 2018Article
- Models of support for disclosure of HIV status to HIV-infected children and adolescents in resource-limited settings.Journal of the International AIDS Society · 2018Article
- Article
- Pediatric HIV Disclosure Intervention Improves Knowledge and Clinical Outcomes in HIV-Infected Children in Namibia.Journal of acquired immune deficiency syndromes (1999) · 2017Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
Optimal pediatric HIV disclosure impacts illness and developmental experiences while improving access to timely treatment. However, disclosure rates in high HIV prevalence countries remain low and there are limited data on best practices. We conducted a qualitative study of disclosure practices and interviewed healthcare providers from five pediatric HIV clinics in Kenya. We identified themes central to disclosure practices, rationale for approaches, barriers to implementing disclosure, and creative strategies to overcome challenges. We used these insights to develop a practice-based framework for disclosure that is sensitive to practical challenges. Overall, providers had limited training but extensive experience in disclosure, endorsed individualized disclosure practices, invested substantial time on disclosure despite clinical burden, and noted adverse outcomes associated with unplanned or abrupt disclosure. Providers advocated for an approach to disclosure that is child-centered but respects caregiver fears and values. Caregiver support was provided to enable caregivers to be the person who ultimately disclosed HIV status to children. Unplanned or abrupt disclosure to children was reported to have severe and persistent adverse impact and was a stimulus to accelerate disclosure in scenarios when providers believed children may be suspecting their diagnosis. Based on these expert insights, the framework we developed incorporates concurrent evaluation of child and caregiver readiness, identifies cues to prompt disclosure discussions, includes caregiver education and support, and utilizes a gradual approach of unveiling HIV diagnosis to the child.
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Registered trials
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