Factors associated with caregiver compliance to an HIV disclosure intervention and its effect on HIV and mental health outcomes among children living with HIV: instrumental variable-based analysis of a cluster randomized trial in Eldoret, Kenya.

Journal: Frontiers in public health

Volume: 11

Issue: 

Year of Publication: 2023

Affiliated Institutions:  Department of Health Systems Design and Global Health, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.

Abstract summary 

The HADITHI study is a cluster-randomized trial of children living with HIV and their caregivers in Kenya that aimed to increase rates of caregiver disclosure of their child's HIV status, encourage earlier status disclosure, and improve pediatric mental health and HIV outcomes. This analysis identified characteristics predicting caregiver non-responsiveness and compared outcomes among children based on disclosure status.A penalized logistic regression model with lasso regularization identified the most important predictors of disclosure. The two-stage least squares instrumental variable approach was used to assess outcomes accounting for non-compliance to disclosure.Caregiver non-isolation and shorter time on antiretroviral therapy were predictive of HIV status disclosure. There were no statistically significant differences found in CD4 percentage, depression status, or mental and emotional status based on disclosure status up to 24 months-post intervention.These findings have implications for specialists seeking to tailor disclosure interventions to improve caregiver-child dyad responsiveness.

Authors & Co-authors:  Magill Nyandiko Baum Aluoch Chory Ashimoshi Lidweye Njoroge Sang Nyagaya Scanlon Hogan Vreeman

Study Outcome 

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Statistics
Citations :  UNAIDS . In Danger: UNAIDS Global AIDS Update 2022. (2022).
Authors :  13
Identifiers
Doi : 1150744
SSN : 2296-2565
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
HIV status disclosure;Kenya;caregiver intervention;mental health;pediatric HIV
Study Design
Study Approach
Country of Study
Kenya
Publication Country
Switzerland