Disclosure of HIV Status to Children in Sub-Saharan Africa: A Systematic Review.

: This study aimed to assess the level of HIV disclosure to children in sub-Saharan Africa as it relates to prevalence of disclosure, barriers, merits and demerits, timing of disclosure, and factors that promote parents and caregivers' decisions to disclose the information. A systematic literature search was performed using the following online databases: PubMed, Google Scholar, Web of Science, Scopus, and Embase, to obtain relevant articles on HIV disclosure to children in sub-Saharan Africa. The following search terms were used: "HIV" AND "Disclosure" AND "Sub-Saharan Africa" AND "Children". A total of 18 articles were included in this systematic review. The studies on HIV status disclosure to children in sub-Saharan Africa included a total of 1343 HIV-positive children and 1879 caregiver/child or healthcare worker-child dyads, from the following countries: Ethiopia, South Africa, Ghana, Kenya, Cote d'Ivoire, Burundi, Cameroon, Democratic Republic of Congo, Uganda, Burkina Faso, and Zambia. The prevalence of HIV disclosure ranged from as low as 9% to 72%. Age was a major factor associated with disclosure. HIV status disclosure to children is quite low in sub-Saharan Africa. This is a result of multiple factors such as parents'/caregivers' fear of the child disclosing status to others, a lack of knowledge on how the disclosure should be made, and the assertion that the children are young and cannot withstand the psychological impact of diagnosis.