title: Disclosure of their status to youth with human immunodeficiency virus infection in the Dominican Republic: a mixed-methods study.
abstract: A mixed-methods study was conducted to determine the proportion of HIV-infected children who knew their status, identify characteristics associated with children's knowledge of their status, and describe caregivers' and adolescents' experiences relevant to disclosure in the Dominican Republic (DR). Of 327 patients aged 6-18 years treated in the principal DR pediatric HIV facilities, 74 (22.6 %) knew their status. Patients aged 13 years or older and/or who had participated in non-clinical activities for HIV-infected children were more likely to know their status. Caregivers who had disclosed cited healthcare providers' advice, children's desire to know and concerns that children might initiate sexual activity before knowing or discover their status by accidental or malicious disclosure. Non-disclosing caregivers worried that children would be traumatized by disclosure and/or stigmatized if they revealed it to others. Adolescents supported disclosure by 10-12 years of age, considered withholding of children's HIV diagnosis ill-advised, and recommended a disclosure process focused initially on promoting non-stigmatizing attitudes about HIV.
authors.affiliation: Robert Stempel College of Public Health and Social Work, Florida International University (FIU), 11200 SW 8th Street, Miami, FL, 33199, USA, becksague@gmail.com.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Beck-Sagué
authors.forename: Maria Claudia
authors.initials: MC
authors.lastname: Pinzón-Iregui
authors.forename: Rosa
authors.initials: R
authors.lastname: Abreu-Pérez
authors.forename: Leonel
authors.initials: L
authors.lastname: Lerebours-Nadal
authors.forename: Christi M
authors.initials: CM
authors.lastname: Navarro
authors.forename: Gladys
authors.initials: G
authors.lastname: Ibanez
authors.forename: Solange
authors.initials: S
authors.lastname: Soto
authors.forename: Mina
authors.initials: M
authors.lastname: Halpern
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Nicholas
authors.forename: Robert
authors.initials: R
authors.lastname: Malow
authors.forename: Jessy G
authors.initials: JG
authors.lastname: Dévieux
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000008:administration & dosage; D017028:Caregivers / Q000523:psychology*; D002648:Child; D004293:Dominican Republic; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D009042:Motivation; D036301:Qualitative Research; D014342:Truth Disclosure
chemical_list: D019380:Anti-HIV Agents