Diagnosis disclosure, medication hiding, and medical functioning among perinatally infected, HIV-positive children and adolescents

Abstract

Little is known about the immunological and virological impact of diagnosis disclosure among HIV-positive children and adolescents. The current cross-sectional study examined medication hiding as a mediator of the relationship between disclosure to friends and three medical outcomes: CD4+ absolute count, CD4+ percentage, and viral load. Participants included 25 perinatally infected, HIV-positive children and adolescents ages 11–18 years from the US. Diagnosis disclosure and medication hiding were self-reported by participants and medical markers were derived from blood samples drawn during the same clinic visit. Bootstrapping analyses revealed that disclosure to at least one friend (versus no friends) was associated with less medication hiding, which was associated with higher CD4+ absolute counts and percentages but not viral load. Further, among the subset of participants who had disclosed to at least one friend (n = 19), those who reported disclosing to 11 or more versus 1–10 friends were less likely to hide medication taking, which was associated with higher CD4+ absolute counts. Findings suggest HIV-positive children and adolescents' diagnosis disclosure to friends corresponds to less medication hiding, ultimately yielding better immune functioning. Health care providers should be cognizant of these potential medical benefits associated with disclosure when offering support around disclosure decision-making.

Keywords:

• pediatric HIV
• disclosure
• HAART
• medical functioning

Acknowledgements

This research was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Center for Cancer Research, as well as Federal Contracts HHSN261200477004C with the Medical Illness Counseling Center and HHSN261200800001E with SAIC-Frederick, Inc. Sarah K. Calabrese was supported by Grant Number F31-MH085584 from the National Institute of Mental Health. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.