“We can tell them, but not right now!”–HIV status disclosure and related factors among children aged 6–14 years living with HIV in Kilimanjaro region, Tanzania

Abstract

In Tanzania, disclosing HIV status to children is challenging despite WHO recommendations to inform children between the ages of 6 and 12 based on cognitive and emotional development. This study aimed to determine HIV status disclosure and related factors among children living with HIV in Tanzania. A study employing quantitative and qualitative methods was conducted from September 2021 to March 2022 among children aged 6–14 receiving HIV care. Semi-structured questionnaires were administered to disclosed and undisclosed children (through their parents/caregivers). The analysis included bivariate and multivariate logistic regression analyses and thematic content analysis for qualitative data. A total of 121 children participated in the quantitative analysis, with 51 (42%) aware of their HIV status. Multivariate analysis showed children aged 9–11 (OR=2.7; 95% CI=0.8–9.0) and 12 years (OR=30; 95% CI=7.2–124) were more likely to know their status than those aged 6-8. Having a treatment supporter/relative (OR=2.9; 95% CI=1.0–8.2) was significantly associated with disclosure. Disclosure was not associated with depression. In-depth interviews revealed themes like disclosure challenges, stigma, and reasons for non-disclosure. HIV status disclosure in Kilimanjaro was associated with age and having a treatment supporter. Addressing age-related challenges and emphasizing the role of treatment supporters can improve disclosure outcomes.