Caregiver disclosure of HIV status and its influence on paediatric ART Adherence at Moi Teaching and Referral Hospital, Uasin Gishu County, Kenya

Abstract

Human Immunodeficiency Virus (HIV) remains a significant public health concern, particularly among children living with the virus. Disclosure of HIV status to infected paediatrics is a critical aspect of care, with potential consequences for treatment adherence, psychological well-being, and long-term health outcomes. Despite worldwide guidelines encouraging age-appropriate disclosure, many caregivers and healthcare providers remain hesitant, resulting in varied disclosure practices. This study aimed to assess the prevailing practices and rates of HIV status disclosure to children and examine how disclosure influences adherence to antiretroviral therapy (ART) among paediatric patients at Moi Teaching and Referral Hospital. The study employed a descriptive survey design guided by Social Cognitive Theory. The target population included 85 children living with HIV, 50 caregivers, and 70 healthcare providers. A census approach was used due to the manageable sample size. Data collection involved structured questionnaires, and analysis was performed using the Statistical Package for Social Sciences (SPSS), generating descriptive statistics including frequencies and percentages. Findings indicated that while some caregivers and providers had embraced disclosure, overall rates of full HIV status disclosure to children remained low. Many caregivers cited fear of psychological harm, stigma, and lack of disclosure training as major barriers. Importantly, children who were aware of their HIV status demonstrated significantly higher adherence to ART compared to those who were not informed. Awareness was also associated with improved understanding of treatment importance and better cooperation with care routines. The study concludes that HIV status disclosure positively influences ART adherence in children. However, persistent barriers hinder widespread implementation of disclosure practices. It is recommended that comprehensive caregiver and provider training programs be implemented, focusing on communication strategies, psychological support, and age-appropriate disclosure techniques. Additionally, post-disclosure support services such as counselling and peer support groups should be established to facilitate better health outcomes in HIV-positive children.