Sankofa pediatric HIV disclosure intervention did not worsen depression scores in children living with HIV and their car
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RESEARCH ARTICLE
Open Access
Sankofa pediatric HIV disclosure intervention did not worsen depression scores in children living with HIV and their caregivers in Ghana Christopher Radcliffe1, Aba Sam1, Quinn Matos1, Sampson Antwi2, Kofi Amissah2, Amina Alhassan2, Irene Pokuaa Ofori2, Yunshan Xu3, Yanhong Deng3, Nancy R. Reynolds4, Elijah Paintsil1* and on Behalf of the Sankofa Team
Abstract Background: The ‘Sankofa’ pediatric HIV disclosure study (2013–2017) was an intervention that aimed to address the low prevalence of disclosure of HIV status in Ghana. Methods: We conducted a cross-sectional study at the intervention site in Kumasi, Ghana, in 2019, (2 years after study closure) and administered the 21-item Beck Depression Inventory (BDI) and the 10-item Child Depression Inventory (CDI) to caregiver-child dyads who received the intervention. Results: We enrolled 65% (N = 157) of the original dyads in the present study. Between Sankofa enrollment baseline and the present study, both children and caregivers had significant (p < 0.0001) mean reductions in CDI scores and BDI scores, respectively. CDI scores of the children were significantly correlated with BDI scores of the caregivers (r = 0.019, p = 0.019). No statistically significant associations between disclosure status and either CDI score or BDI score were found. Conclusions: Our findings did not support caregivers’ fears that disclosure leads to depression. Trial registration: ClinicalTrials.gov Identifier: NCT01701635 (date of registration Oct 5, 2012). Keywords: Pediatric HIV, Disclosure intervention, Depression, Ghana
Background In 2018, there were 2.8 million children and adolescents living with HIV globally [1]. Unfortunately, sub-Saharan Africa has been disproportionately affected by the HIV epidemic, and it is home to nearly 90% of children and adolescents living with HIV [1]. There has been an unprecedented effort to scale up antiretroviral therapy (ART) in sub-Saharan Africa. With expanding ART coverage in subSaharan Africa, children living with HIV are living longer * Correspondence: [email protected] 1 Department of Pediatrics, Pharmacology & Public Health, Yale School of Medicine, 464 Congress Avenue, New Haven, CT 06520, USA Full list of author information is available at the end of the article
and surviving into adulthood due to declines in AIDSrelated deaths [2, 3]. However, these gains can be reversed when adherence to ART is sub-optimal. Sustained viral suppression is the goal of optimal adherence (≥95%), and there are several efforts and strategies focused on ensuring this level of adherence along the HIV care continuum, particularly in children living with HIV [4, 5]. Nevertheless, there are reports of poor adherence among children living with HIV leading to virologic or treatment failure [6, 7]. Non-disclosure of HIV status to children living with HIV is a critical barrier to optimal adherence to therapy [8]. There is a growing body of evidence to support the benefits of
© The Author(s). 2020 Open Access This article is license
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