Disclosure of HIV status and its association with quality of life and depressive symptoms among children with HIV in North-Eastern Tanzania

BACKGROUND: Disclosing HIV status to children with HIV (CWHIV) is associated with improved antiretroviral therapy (ART) adherence, quality of life, and psychosocial well-being in many sub-Saharan Africa. However, little is known about this in Tanzania. We determine the prevalence of HIV status disclosure and its association with health-related quality of life (HRQOL) and depressive symptoms in CWHIV in the Tanga Region, Tanzania. METHODS: A cross-sectional study was conducted in 11 public HIV clinics among caregiver-CWHIV pairs in 2023. Data were collected on socio-demographic, child's HIV disclosure, depressive symptoms, ART adherence, and HRQOL. Multiple linear and negative binomial regression analyses assessed associations between independent variables (HIV disclosure/other factors) and HRQOL (primary outcome), and depressive symptoms (secondary outcome), respectively. RESULTS: Two hundred and seventy-eight CWHIV aged 8-14 years and their caregivers were enrolled. Most caregivers (80.58%) were female. Three-quarters (75.90%) of CWHIV knew their HIV status. Two-thirds (68.71%) of CWHIV reported adherence to ART. HIV disclosed versus non-disclosed CWHIV had 4.57 units higher HRQOL (coefficient = 4.57, 95% CI: 0.87, 8.27; p = 0.016). Higher depression scores (coefficient = -1.09, 95% CI: -1.30, -0.87; p < 0.001 and ART non-adherence (coefficient = -4.27, 95% CI: -7.07, -1.48, p = 0.003) were inversely associated with HRQOL. There was no significant association between HIV disclosure and depressive symptoms, whereas ART non-adherence was significantly associated with higher depressive symptom scores (coefficient = 0.28, 95% CI: 0.06, 0.49, p = 0.013). CONCLUSION: HIV disclosure was associated with better HRQOL but not with any worsened depressive symptoms. Interventions that promote HIV status disclosure at the recommended age are therefore important in the care of CWHIV.