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

Frontiers in Public Health

Public Health

Josephine Aluoch¹  Jack Nyagaya¹  Festus Sang¹  Celestine Ashimoshi¹  Janet Lidweye¹  Tabitha Njoroge¹  Michael Scanlon²  Joseph Hogan³  Winstone Nyandiko⁴  Elizabeth B. Magill⁵  Ashley Chory⁵  Aaron Baum⁵  Rachel Vreeman⁶ 

[1] Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;Center for Global Health, Indiana School of Medicine, Bloomington, IN, United States;Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;Department of Biostatistics, Brown University School of Public Health, Providence, RI, United States;Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;Department of Child Health and Pediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya;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;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;

关键词: mental health;    Kenya;    pediatric HIV;    HIV status disclosure;    caregiver intervention;   

DOI  :  10.3389/fpubh.2023.1150744

 received in 2023-02-02, accepted in 2023-04-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe 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.MethodsA 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.ResultsCaregiver 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.ConclusionThese findings have implications for specialists seeking to tailor disclosure interventions to improve caregiver-child dyad responsiveness.

【 授权许可】

Unknown   
Copyright © 2023 Magill, Nyandiko, Baum, Aluoch, Chory, Ashimoshi, Lidweye, Njoroge, Sang, Nyagaya, Scanlon, Hogan and Vreeman.