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

Autor: Elizabeth B. Magill, Winstone Nyandiko, Aaron Baum, Josephine Aluoch, Ashley Chory, Celestine Ashimoshi, Janet Lidweye, Tabitha Njoroge, Festus Sang, Jack Nyagaya, Michael Scanlon, Joseph Hogan, Rachel Vreeman
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Public Health, Vol 11 (2023)
Druh dokumentu: article
ISSN: 2296-2565
DOI: 10.3389/fpubh.2023.1150744
Popis: 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.
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