The Factors Influencing the HIV status Disclosure among Children Aged 2 - 14 Years in Songwe

region in 2023: A Cross Sectional Study

1* 1 1 1 1
Filberth F. Ilaza , Vicent Josephat J , Gabriel J. Hatari , Hendri A. Thobias , James C. Dotto ,
1 2 2*
Isamulah M. Kilalo , Zablon Zakayo , Bernard Mbwele

Affiliations
1. Medical students
University of Dar es Salaam - Mbeya College of Health and Allied Sciences (UDSM-
MCHAS), P.O Box 608 Mbeya, Tanzania

2. Department of Epidemiology, Biostatistics and Clinical Research

University of Dar es Salaam - Mbeya College of Health and Allied Sciences (UDSM-
MCHAS), P.O Box 608 Mbeya, Tanzania

Abstract
Background
HIV status disclosure among children on antiretroviral treatment has been highly associated with the
outcome of pediatric HIV care. There are factors attributing delays or complicated approach of HIV status
disclosure among children due to stigma. We aimed at determining the HIV status Disclosure among
children in Songwe region of Tanzania.

Methods
The cross-sectional hospital-based was conducted in 6 hospitals in April, 2023 to identify the magnitude
and factors affecting HIV status disclosure among children aged 2-14 years. Convenient and Systematic
random sampling was used to identify patient files with data extraction by a validated case report form.
Analysis was conducted using STATA v-16 for univariate, bivariate Chi-square, logistic and finally
multivariate logistic regression was executed at 95% Confidence Interval (95% CI).

Results
A total of 291 children files were studied with age 8.6 ± 4.3 ranging from 0.89 to 14.7 years. A total of 103
children (35.4%) received disclosure of their HIV/AIDS status while 188 (64.6%) were not disclosed their
2
HIV/AIDS status. Among the disclosed 73 were females (70.9) and 30 males (29.1%) Pearson X (1) =
2
49.3, p value <0.001. Age of 5 – 10 years 40 (38.8%) and 10 -14 years 63(61.2%) X (1) = 92.3, p value
2 2 2
<0.001. WHO stage X (3) = 55.4, p value <0.001, Viral Load X (2) = 115.06, CD4 Count X (4) = 1.539,
p=0.820. Age of 10-15 years AOR =11.1, 95%CI (1.6 - 73.6), p=0.013, female AOR = 4.0, 95%CI(1.2 -
13.3) p= 0.024, WHO stage 3 AOR=6.0 95%CI(1.3 - 27.5) p= 0.021, WHO stage 4 AOR=10.3 95%CI
(1.7 - 60.0) p= 0.01, Viral Load 0-50 cell/ml AOR = 0.4 95%CI (0.05 - 2.7), p=0.3 Viral Load >1000
copies/ml AOR =28.6 95%CI (7.2 - 112.5) p<0.001.

Conclusion
The disclosure rate is less than half mostly affected by age above 10 years, female sex, higher WHO
stage, Viral load higher than 1000 copies/ml.
 Odds [95%
HIV Disclosure Ratio Std. Err. z P>z Conf. Interval]
Age
5-9 4.719002 4.892417 1.5 0.134 0.618541 36.00243
10 -14 11.12088 10.72685 2.5 0.013 1.679178 73.65147

Sex
Female 4.000487 2.452096 2.26 0.024 1.203288 13.30014

WHO stage
Stage 2 1.74823 1.978805 0.49 0.622 0.190166 16.07183
Stage 3 6.017807 4.669161 2.31 0.021 1.315221 27.53454
Stage 4 10.29809 9.261057 2.59 0.01 1.767148 60.01238

VLCat2
VL <50 copies /ml 0.378138 0.379443 -0.97 0.332 0.052907 2.702648
VL >1000 copies / ml 28.58415 19.98745 4.79 0 7.259774 112.5453