**7. Conclusion**

The low rate of disclosure of HIV status to children found in the study indicates that it is a priority to develop disclosure clinical model in the Colombian context. For this reason since 2008 our institution is conducting the investigation: "Evaluation of the effects of a disclosure clinical model in HIV-positive children 7 – 18 years old in adherence to treatment and psychological adjustment". Research Project awarded with the Fellowship for Research from the Department of Research and Projects. Awarded in the 2008 Call for Proposals for Doctorate Programs at Universidad del Norte

This research aims to provide a clinical model to help affected families overcome fears that lead them to delay the delivery of HIV diagnosis. Mainly, caregivers want to avoid psychological or emotional harm to child and they fear that child tell the diagnosis to others and be discriminated against.

Affectation Situation of HIV/AIDS in Colombian Children 281

Abadía-Barrero C & Larusso M. The Disclosure Model versus a Developmental Illness

Bikaako-Kajura W, Luyirika E, Purcell DW, Downing J, Kaharuza F, Mermin J., et al.

Brandt P. A. & Weinert C. The PRQ-A social support measure. *Nurs. Res*. 30, 277-280,

Broadhead W. E., Gehlbach S. H., DeGruy F. V. and Kaplan B. H. The Duke-UNC

Brown S P., Brady T., Lent R. W., Wolfert J. and Hall S. Perceived social support

Casado A, Consiglio E, Podzamaczer D, Badia X. Highly active antirretroviral treatment

Cohen S & Hoberman H. Positive events and social supports as buffers of life change

Cohen S., Mermelstein R., Kamarck T. & Hoberman H. *Measuring the functional* 

Cohen FL. Research on families and pediatric human immunodeficiency virus disease: A

Cohen S. & Syme S L. *Issues in the study and application of social support*. In Social Support and Health (Edited by Cohen S. and Syme S. L.). Academic, Orlando, 1985 Cohen S. & Wills T. A. *Stress, social support, and the buffering hypothesis*. Psychol. Bull. 98,

Committee on Pediatric Aids. Disclosure of illness status to children and adolescents with

Call SA, Klapow JC, Stewart KE, et al. Health-related quality of life and virologic outcomes

Davis J K & Shah K. Bioethical aspect of HIV infection in children. *Clinical Pediatrics* 1997, 36,

family medicine patients. *Med. Care* 26, 709-721, 1988.

(Edited by Sarason I.). Martines Nijhoff. Holland, 1985.

patients. *HIV Clin Trials* 2001; 2:477–82.23.

stress. *J. appl. Sot. Psycho*/13, 99-125, 1983.

HIV infection. *Pediatrics* 1999.103:164-166.

in an HIV clinic. *Qual Life Res* 2000; 9:977–85.

infected children in Uganda. *AIDS Behaviour* 2006, 10(Suppl. 4), S85-S93. Boon-Yasidhi V, Kottapat U, Durier Y, Plipat N, Phongsamart W, Chokephaibulkit K &

Paulo, Brazil. *AIDS Patient Care and STDs* 2006. Volume 20, Number 1. Ahumada R, Castillo L, Muñoz B y Moruno M. Validación del Cuestionario MOS de Apoyo Social en Atención Primaria. *Medicina de Familia (And)* Vol. 6, N.º 1, abril 2005 Barrera M. *Social support in the adjustment of pregnant adolescents: assessment issues*. In Social

Experience Model for Children and Adolescents Living with HIV/AIDS in São

Nerworks and Social Support (Edited by Gottlieb B.). Sage, Beverly Hills, CA

Disclosure of HIV status and adherence to daily drug regimens among HIV-

Vanprapar N. Diagnosis Disclosure in HIV-Infected Thai Children*. J Med Assoc Thai*

Functional Social Support Questionnaire: Measurement of social support in

among college students: Three studies of the psychometric characteristics and counseling uses of the social support inventory. *J. Counseling Psycho*/34, 337-

(HAART) and health-related quality of life in naïve and pretreated HIV-infected

*components of social support*. In Social Support: Theory, Research and Applications

review and needed directions. *Developmental and Behavioral Pediatrics* 1994, 15(3),

**9. References** 

198 1.

2005.

1981.

354, 1987.

S34-S42.

573-579.

310-357. 1985.

According to the above, health professionals do not know for sure at what age a child should know their HIV diagnosis. Some believe that at 10 years a child is old enough to manage this information. Some believe that children should learn about biosecurity practices and adherence to treatment without knowing the diagnosis in a playful way, through stories, comics and other fun techniques. Health professionals recognize that children perceive that something happens with his/her bodies by going through periods of illness and drugs.

Caregivers and health professionals explain to children that drugs are for flu, pneumonia, heart problems, fever and other low-impact diseases, but do not tell the child that he/she has HIV/AIDS.

Colombian families interviewed showed a positive degree of satisfaction with Family Functioning and Social Support. Children have good quality of life, low virus load and have access to Antiretroviral Treatment. Some barriers were identified in health services utilization.

On the other hand, we consider important to offer some recommendations to access to Colombian children affected with HIV/AIDS. Not all health services in the Colombia cities have pediatrics patients with HIV. Once identified health services, health teams evaluate the research protocol, this assessment could take 2 or 3 months. Also, it is important to know that caregivers take children to health services once a month and informed consent must be obtained through a detailed explanation of the research and get his/her signature as the child's legal representative.

Health services should provide to researches a private place for interviews. Many health services were not including in this study for lack of such space.

This type of researches must have a budget to be allocated to pay transportation costs of caregivers and HIV-positive children. These families have economic limitations to move to health services.

Another recommendation is to consider extending the running time for such studies because of the difficulties identified in the location and recruitment of subjects.
