**5. Clinical status of children with HIV/AIDS**

Health-related quality of life (HRQOL) is increasingly recognized as an important measure for assessing the burden of chronic diseases (Hays et al., 2000). HIV-specific parameters, such as low CD4 cell count and high virus load, have previously been shown to adversely affect HRQOL in some studies of HIV-infected patients (Casado et al., 2011; Niuwerk et al., 2001).

Other studies show weak HRQOL associations with disease stage and CD4 cell count (Niuwerk et al., 2001). Similarly, the effect of HAART on HRQOL has been assessed with some studies (Call et al., 2000).

According to international definitions on the concept of childhood affected by HIV/AIDS, participating minors must comply with the following affectation categories as criteria of population inclusion, nonexcluding amongst themselves: 1. HIV/AIDS seropositive and/or seronegative children, and adolescents, orphaned by HIV/AIDS (father, mother, or both deceased because of the disease). 2. HIV seropositive children and adolescents. 3. HIV seropositive and/or seronegative children and adolescents, cohabitating with HIV seropositive individuals.

80 children were HIV-positive in five Colombia cities. 80% (N=64) were receiving antiretroviral therapy and most 34.9% (N=30) had HIV load undetectable or low 20% (N=15) (See Table 4). As we mentioned earlier, Colombian children affected with HIV/AIDS have a good level of health because all these children are affiliated to the social security health and are receiving Highly Active Antiretroviral Treatment (HAART); 80% (N=64) children are receiving HAART (See Table 4).


Table 4. Viral Load and Antiretroviral Therapy in HIV-positive children.

Affectation Situation of HIV/AIDS in Colombian Children 279

Table 6. Barriers of Health Services in Colombian families affected with HIV/AIDS.

87.4% of Families affected with HIV reports that health attention has not been denied (See

**(N=286) F % YES** 36 12.6 % **NO** 250 87.4 %

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

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

Table 7. Denial of Health Services in Colombian families affected with HIV/AIDS.

**Discretion and Confidentiality Service (N=286)** 

**Home Care (N=286)** 

**Entity that subsidizes Antiretroviral Therapy (N=64)** 

**Acquisition of Antiretroviral Therapy with own money (N=64)** 

Doctorate Programs at Universidad del Norte

and be discriminated against.

**Denial of Health Services**

Table 7).

**7. Conclusion** 

**Barriers to Health Services Category N %** 

Yes 265 92.7% No 20 7% Sometimes 1 0.3%

Monthly 4 1.4% 2 to 3 months 14 4.9% Every 6 months 7 2.4% 1 time per year 16 5.6% Never 245 85.7%

lender (EPS) 6 10.4%

(ARS) 33 50.6%

Yes 4 6.7% No 60 93.3%

21 32.5%

Subsidized by the foundation 4 6.5%

Subsidized by the health

Subsidized insurance scheme

Subsidized by distrital or departamental health secretary
