title: HIV disclosure and its effect on treatment outcomes in perinatal HIV-infected Thai children.
abstract: The World Health Organization guideline recommends informing children of their HIV status between the ages of 6-12 years. Primary caregivers of perinatal HIV-infected Thai children ≥6 years were interviewed in order to assess the HIV status disclosure rate. In addition, pill counts of antiretroviral therapy (ART) were performed every three months. CD4 and HIV-RNA were performed every six months. Of the 260 children/adolescents included, the median age of disclosure was 14.8 years. The disclosure rate among those from 6 to 12 years was 21% and for those greater than 12 years of age was 84%. When comparing children aged 6-12 years whose HIV status had been disclosed to them, to children whose HIV had yet to be disclosed, no difference was noted in median ART adherence by pill count, CD4 count, or proportion of HIV-RNA <50 copies/ml (p > 0.05). Factors associated with HIV disclosure were an age of ≥12 years (OR 17.8, 95% CI 8.86-35.79) and a current CD4 ≤ 30% (OR 2.09, 95% CI 1.20-3.62). In conclusion, although the majority of adolescents ≥12 years were aware of their HIV status only one-fifth of children aged 6-12 years were aware. Moreover, the child's/adolescent's disclosure status had no bearing on ART adherence by pill count or immunological and virological outcomes.
authors.affiliation: a The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT) , The Thai Red Cross AIDS Research Center , Bangkok , Thailand.
authors.forename: Chompoonoot
authors.initials: C
authors.lastname: Sirikum
authors.forename: Jiratchaya
authors.initials: J
authors.lastname: Sophonphan
authors.forename: Thongsuai
authors.initials: T
authors.lastname: Chuanjaroen
authors.forename: Sudrak
authors.initials: S
authors.lastname: Lakonphon
authors.forename: Amornrat
authors.initials: A
authors.lastname: Srimuan
authors.forename: Patcharaporn
authors.initials: P
authors.lastname: Chusut
authors.forename: Tanya C
authors.initials: TC
authors.lastname: Do
authors.forename: Wasana
authors.initials: W
authors.lastname: Prasitsuebsai
authors.forename: Thanyawee
authors.initials: T
authors.lastname: Puthanakit
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Torsak
authors.initials: T
authors.lastname: Bunupuradah
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002648:Child; D030881:Disclosure; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D011446:Prospective Studies; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents
keywords: HIV disclosure; HIV-infected children; treatment outcomes