Stigma, caregiver-provider discussions, and ART duration as key determinants of HIV status disclosure to children in Central Ethiopia

Disclosure of HIV-positive status to children is a critical component of long-term disease management and care. However, stigma, lack of caregiver-provider discussions, and varying durations on antiretroviral therapy (ART) pose significant barriers to disclosure. This study aimed to assess the prevalence of HIV status disclosure and its associated factors, with a focus on stigma, caregiver-provider discussions, and ART duration, among children on ART in Central Ethiopia. A facility-based cross-sectional study was conducted among 375 caregivers of children living with HIV aged 6-18 years in selected health facilities in Central Ethiopia. Data were collected using structured questionnaires through face-to-face interviews. Descriptive statistics, bivariable, and multivariable logistic regression analyses were performed using STATA version 14. Variables with a p-value < 0.05 were considered statistically significant. The prevalence of HIV status disclosure to children was 41.8% (95% CI: 36.9-47.6). Caregiver-provider discussions about disclosure (AOR = 2.17, 95% CI: 1.20-3.93), longer ART duration (AOR = 1.63, 95% CI: 1.01-2.63), and reduced fear of stigma (AOR = 2.10, 95% CI: 1.36-3.25) were independently associated with higher rates of disclosure. These findings align with the WHO recommendations and Ethiopian National Guidelines, which emphasize the importance of healthcare provider involvement, age-appropriate disclosure, and stigma reduction. The prevalence of HIV status disclosure remains low in Central Ethiopia. Stigma, caregiver-provider discussions, and ART duration are key determinants of disclosure. Interventions should focus on strengthening caregiver-provider communication, addressing stigma, and supporting children on long-term ART to improve disclosure rates and overall health outcomes.