**3. Health-Related Quality of Life (HRQOL) in children affected with HIV/AIDS**

Advances in HIV treatment have allowed that quality of life of people affected with HIV/AIDS increased. Quality of Life related to Health subscales provides an overall vision of health and allows make important decisions about patient care. To have a benchmark of the health status of the pediatric patient should be a priority for institutions that provide health services.

For this reason we use EuroQol (EQ-5D) to estimate how Colombian caregivers perceive the Health-Related Quality of Life of their children. EQ-5D is a standardized instrument for use as a measure of health outcome. Applicable to a wide range of health conditions and treatments, it provides information about mobility, self-care, usual activities, pain/discomfort and anxiety/depression.

Results shows in Mobility subscale that 94.4% (N=269) of children with HIV/AIDS do not have trouble walking, 5.6% (N=17) have some problems or confined to bed. In Self-Care subscale, 96.1% (N=275) do not have problems bathing or dressing; 3.9% (N=11) of children have some problems or are unable to bathing or dressing. In Usual Activities subscale results shows that 96.1% (N=275) do not have problems to perform their usual activities, 3.9% (N=11) of children have some problems or are unable to perform their usual activities. In Pain/Discomfort subscale caregivers perceive that 84.6% (N=242) of their children do not

Colombian caregivers were afraid that the child would get depressed, be isolated, anxious or worried about having this chronic disease. Caregivers also fear that once the illness status is disclosed, the child will tell others, which will lead him and his family to situations of stigma and discrimination with potentially serious consequences such as expulsion from residence, school, and refusal to play with the child, among others. Similarly, professionals who provide health services to these children showed a lack of consensus on the procedure

Researchers found that children were aware of their illness and impending death, despite their parent´s stance of protective communication. (Hardy et al., 1994). Given the number of visits they make to the hospital or clinic and the acquaintances they meet, complete unawareness by a certain age is doubtful. Although kept in secrecy, children often showed curiosity or knowledge about their treatments (Lee & Johann-Liang, 1999). They may listen in on a conversation about AZT treatment between the doctor and their parent or ask other patients about their condition (Lipson, 1993). The stigma of HIV/AIDS leads families to

The American Academy of Pediatrics guidelines for the illness status disclosure to children and adolescents with HIV infection says it is imperative that all adolescents have knowledge of their illness status and that disclosure should be considered for children under school age according to their level of cognitive development, age, family dynamics, psychosocial

Disclosure of HIV diagnosis to children is becoming increasingly important because antiretroviral therapy becomes more widely available, however internationally rates of disclosure seem to be low. Some factors can inhibit and facilitate the decision making of

Disclosure of HIV diagnosis should be viewed as a process, rather than an event, it is related to the child's cognitive development and aims to provide him/her with age appropriate

**3. Health-Related Quality of Life (HRQOL) in children affected with HIV/AIDS**  Advances in HIV treatment have allowed that quality of life of people affected with HIV/AIDS increased. Quality of Life related to Health subscales provides an overall vision of health and allows make important decisions about patient care. To have a benchmark of the health status of the pediatric patient should be a priority for institutions

For this reason we use EuroQol (EQ-5D) to estimate how Colombian caregivers perceive the Health-Related Quality of Life of their children. EQ-5D is a standardized instrument for use as a measure of health outcome. Applicable to a wide range of health conditions and treatments, it provides information about mobility, self-care, usual activities, pain/discomfort and

Results shows in Mobility subscale that 94.4% (N=269) of children with HIV/AIDS do not have trouble walking, 5.6% (N=17) have some problems or confined to bed. In Self-Care subscale, 96.1% (N=275) do not have problems bathing or dressing; 3.9% (N=11) of children have some problems or are unable to bathing or dressing. In Usual Activities subscale results shows that 96.1% (N=275) do not have problems to perform their usual activities, 3.9% (N=11) of children have some problems or are unable to perform their usual activities. In Pain/Discomfort subscale caregivers perceive that 84.6% (N=242) of their children do not

keep the diagnosis secret from the child, other family members and schools.

maturity and other clinical variables (Committee on Pediatric AIDS [COPA], 1999).

caregivers to disclose illness status to their children with HIV/AIDS (See Figure 1).

and age for disclosing illness status.

information.

that provide health services.

anxiety/depression.

have pain or discomfort, however 15.4% (N= 44) of children have some problems or may be experiencing pain and discomfort. Finally, caregivers perceive that 90.2% (N=258) of their HIV-positive children do not have anxiety or depression while 9.8% (N=28) may be experiencing anxiety or depression according to caregiver's report (See Table 1.)


Table 1. Health-Related Quality of Life (HRQOL) in Colombian children affected with HIV/AIDS measured by their caregivers.

The above results indicate that Colombian children affected with HIV/AIDS have a good level of health. Worth noting that all these children are affiliated to the social security health and are receiving Highly Active Antiretroviral Treatment (HAART). However, the highest percentage of problems found in Pain/Discomfort subscale with 15.4% of children who have some problems or may be experiencing pain and discomfort according to caregiver's report.

(The World Health Organization [WHO], 2003) defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. It follows that measurement of health must not only include estimates of the frequency and severity of diseases, but also well-being and quality of life. This is particularly true for patients with HIV/AIDS because of the chronic and debilitating nature of the illness, stigma, and a high rise of premature death (Nojomi et al., 2008).
