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Meless GD. , Aka-Dago-Akribi H., Cacou C., Aka AE., Oga AC.,

Disclosure of HIV test results in HIV-infected adolescents in the Aconda program (CePReF, CHU Yopougon) in Abidjan, Côte d’Ivoire: The Project PRADO-CI. Meless GD. , Aka-Dago-Akribi H., Cacou C., Aka AE., Oga AC., Bouah B., Kouao L, Messou E., Tanoh FE, Moh C.,

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Meless GD. , Aka-Dago-Akribi H., Cacou C., Aka AE., Oga AC.,

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  1. Disclosure of HIV test results in HIV-infected adolescents in the Aconda program (CePReF, CHU Yopougon) in Abidjan, Côte d’Ivoire: The Project PRADO-CI Meless GD., Aka-Dago-Akribi H., Cacou C., Aka AE., Oga AC., Bouah B., Kouao L, Messou E., Tanoh FE, Moh C., Timité-Konan M. and Leroy V. for the PRADO-CI Group

  2. Background (1) • With antiretroviral treatment (ART) access in HIV-infected children, HIV-infected adolescents are an emerging population • Adolescence is a vulnerable period • Emotional and behavioral disorders • Problem of treatment adherence • Problem of program retention • Problem of mutiple previous ART regimens

  3. Background (2) • An HIV diagnosis is a life-changing event • Especially in adolescents, the disclosure of the HIV test result • Is essential for HIV prevention • May accentuate behavioral disorders • May improve ART adherence • Could impact on ART outcomes 3

  4. Objective To study the prevalence of the disclosure of HIV test result and its association with their baseline characteristics in ART-treated adolescents in Abidjan, Côte d’Ivoire 4

  5. Methods (1) • Since 2004: Aconda Program in Côte d’Ivoire • Pediatric care, with free HIV diagnosis and ART access in HIV-infected children • Funding: EGPAF/PEPFAR • Collaboration: Inserm U897/ISPED, Bordeaux • Current active file: 2244 HIV+ children (1000 on ART)

  6. Methods (2) • The PRADO-CI Study • Cross-sectional study nested in the Aconda active file • Psycho-social and behavioral difficulties and their determinants in adolescents • Funding: Sidaction

  7. Methods (3) • Inclusion criteria • HIV-infected adolescents • Aged 13 to 21 years, • Seen at least once in 2009 • in two urban centers of the Aconda program in Abidjan

  8. Methods (4) • Data collection: medical records • Demographic (age, sex ...) • Drugs: Cotrimoxazole prophylaxis, ART • HIV disclosure documented in chart • Formal: provided by medical team • Informal: through another source • % and correlates of disclosure, logistic regression

  9. Results (1) 9

  10. Univariate logistic regression correlates of documented HIV disclosure (N=194) 10

  11. Univariate logistic regression correlates of documented HIV disclosure (N=194) 11

  12. Discussion (1) • Documented disclosure rate is low in this population • 33% • Proportion of adolescents informed of their HIV infection increases with • Age • CTX prophylaxis • ART

  13. Discussion (2) • HIV adolescents • Frequent care centers regularly • Take drugs daily • Can read • But, are not informed of their HIV status What do they know exactly about their serostatus ?

  14. Conclusions Need for … • practical interventions to support HIV disclosure to adolescents • age-appropriate information about the disease • systematic documentation in medical records • further understand what this «lack of clear information» means in the PRADO-CI study • Sociologic and psychologic interview • Psychologic test (GPPI, Rorschach) • Focus group

  15. The PRADO-CI Study Group MINISTERE DE LA LUTTE CONTRE LE SIDA • Investigators • Dr H. Aka Dago-Akribi (Université de Cocody, Abidjan), • Dr V. Leroy (Inserm U897, ISPED, Bordeaux) • Abidjan • Département de Psychologie, Université de Cocody : H. Aka-Dago-Akribi, B. Bouah, MC. Cacou, C. Moh • Programme PACCI : L. Kouao, M. Oga, D. Meless • Service de pédiatrie,CHU de Yopougon : Pr Timité-Konan Dr FE Tanoh • CePReF : Dr EA Aka, Dr E. Messou • Association CHIGATA

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