2012. 8 p.
Pediatric leDEA West Africa Working Group
The authors assessed the effect of HIV status disclosure on retention in care from initiation of antiretroviral therapy (ART) among HIV-infected children ages 10 years or more in Cote d'Ivoire, Mali and Senegal. They conducted a multi-center cohort study within five pediatric clinics participating in the IeDEA West Africa collaboration. HIV-infected patients were included in this study if they met the following inclusion criteria: ages 10–21 years while on ART; having initiated ART ≥200 days before the closure date of the clinic database; followed ≥15 days from ART initiation in clinics with ≥10 adolescents enrolled. Routine follow-up data were merged with those collected through a standardized ad hoc questionnaire on awareness of HIV status. Probability of retention (no death or loss-to-follow-up) was estimated with Kaplan-Meier method. Cox proportional hazard model with date of ART initiation as origin and a delayed entry at date of 10th birthday was used to identify factors associated with death or loss-to-follow-up. Six hundred and fifty adolescents were available for this analysis. About two-thirds of HIV-infected adolescents on ART were not aware of their HIV status in these ART clinics in West Africa, but disclosed HIV status improved retention in care. The disclosure process should be thus systematically encouraged and organized in adolescent populations.
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