r2d2.bib

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@article{chaudoir:2011,
	Abstract = {HIV disclosure is a critical component of HIV/AIDS prevention and treatment efforts, yet the field lacks a comprehensive theoretical framework with which to study how HIV-positive individuals make decisions about disclosing their serostatus and how these decisions affect them. Recent theorizing in the context of the Disclosure Processes Model has suggested that the disclosure process consists of antecedent goals, the disclosure event itself, mediating processes and outcomes, and a feedback loop. In this paper, we apply this new theoretical framework to HIV disclosure in order to review the current state of the literature, identify gaps in existing research, and highlight the implications of the framework for future work in this area.},
	Author = {Chaudoir, Stephenie R. and Fisher, Jeffrey D. and Simoni, Jane M.},
	Date-Added = {2017-12-24 12:05:28 +0000},
	Date-Modified = {2017-12-24 12:06:15 +0000},
	Journal = {Social Science \& Medicine},
	Number = {10},
	Pages = {1618--1629},
	Title = {Understanding {{HIV}} disclosure: {{A}} review and application of the {{Disclosure Processes Model}}},
	Volume = {72},
	Year = {2011},
	Bdsk-Url-1 = {http://www.sciencedirect.com/science/article/pii/S0277953611001912},
	Bdsk-Url-2 = {https://dx.doi.org/10.1016/j.socscimed.2011.03.028}}

@article{wiener:2006,
	Author = {Wiener, Lori S and Battles, Haven B.},
	Date-Added = {2017-12-22 15:12:45 +0000},
	Date-Modified = {2017-12-22 15:14:20 +0000},
	Journal = {Journal of Adolescent Health},
	Number = {3},
	Pages = {307--309},
	Publisher = {Elsevier},
	Title = {Untangling the web: a close look at diagnosis disclosure among {HIV}-infected adolescents},
	Volume = {38},
	Year = {2006}}

@techreport{zimcensus:2012,
	Author = {{ZNSA}},
	Date-Added = {2017-12-22 12:39:10 +0000},
	Date-Modified = {2017-12-22 12:40:39 +0000},
	Institution = {{Zimbabwe National Statistics Agency}},
	Title = {{Zimbabwe Population Census 2012}},
	Url = {http://www.zimstat.co.zw/sites/default/files/img/National_Report.pdf},
	Year = {2012},
	Bdsk-Url-1 = {http://www.zimstat.co.zw/sites/default/files/img/National_Report.pdf}}

@article{wiener:1996,
	Abstract = {Abstract: Disclosure of the diagnosis of human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) to a child is a...},
	Author = {Wiener, Lori S. and Battles, Haven B. and Heilman, Nancy and Sigelman, Carol K. and Pizzo, Philip A.},
	Date-Added = {2017-12-22 12:35:51 +0000},
	Date-Modified = {2017-12-22 12:36:57 +0000},
	Journal = {Pediatric AIDS and HIV Infection},
	Number = {5},
	Pages = {310--324},
	Title = {Factors associated with disclosure of diagnosis to children with {HIV/AIDS}},
	Volume = {7},
	Year = {1996},
	Bdsk-Url-1 = {http://europepmc.org/abstract/med/11361489}}

@article{vreeman:2010,
	Abstract = {In resource-limited settings, beliefs about disclosing a child's HIV status and the subsequent impacts of disclosure have not been well studied. We sought to describe how parents and guardians of HIV-infected children view the impact of disclosing a child's HIV status, particularly for children's antiretroviral therapy (ART) adherence. A qualitative study was conducted using involving focus groups and interviews with parents and guardians of HIV-infected children receiving ART in western Kenya. Interviews covered multiple aspects of the experience of having children take medicines. Transcribed interview dialogues were coded for analysis. Data were collected from 120 parents and guardians caring for children 0--14 years (mean 6.8 years, standard deviation [SD] 6.4); 118 of 120 had not told the children they had HIV. Children's caregivers (parents and guardians) described their views on disclosure to children and to others, including how this information-sharing impacted pediatric ART adherence, children's well-being, and their social relationships. Caregivers believed that disclosure might have benefits such as improved ART adherence, especially for older children, and better engagement of a helping social network. They also feared, however, that disclosure might have both negative psychological effects for children and negative social effects for their families, including discrimination. In western Kenya, caregivers' views on the risks and benefits to disclosing children's HIV status emerged a key theme related to a family's experience with HIV medications, even for families who had not disclosed the child's status. Assessing caregivers' views of disclosure is important to understanding and monitoring pediatric ART.},
	Author = {Vreeman, Rachel C. and Nyandiko, Winstone M. and Ayaya, Samwel O. and Walumbe, Eunice G. and Marrero, David G. and Inui, Thomas S.},
	Date-Added = {2017-12-22 12:32:48 +0000},
	Date-Modified = {2017-12-22 12:34:24 +0000},
	Journal = {AIDS Patient Care and STDs},
	Number = {10},
	Pages = {639--649},
	Title = {The perceived impact of disclosure of pediatric {HIV} status on pediatric antiretroviral therapy adherence, child well-being, and social relationships in a resource-limited setting},
	Volume = {24},
	Year = {2019},
	Bdsk-Url-1 = {http://online.liebertpub.com/doi/abs/10.1089/apc.2010.0079},
	Bdsk-Url-2 = {https://dx.doi.org/10.1089/apc.2010.0079}}

@electronic{unaidsfact:2017,
	Author = {UNAIDS},
	Date-Added = {2017-12-22 12:27:01 +0000},
	Date-Modified = {2017-12-22 12:28:29 +0000},
	Title = {{Fact Sheet: World AIDS Day 2017}},
	Url = {http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf},
	Year = {2017},
	Bdsk-Url-1 = {http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf}}

@article{butler:2009,
	Abstract = {BACKGROUND. Little is known concerning the impact of HIV status disclosure on quality of life, leaving clinicians and families to rely on research of children with other terminal illnesses.
OBJECTIVES. The purpose of this work was to examine the impact of HIV disclosure on pediatric quality of life and to describe the distribution of age at disclosure in a perinatally infected pediatric population.
METHODS. A longitudinal analysis was conducted of perinatally HIV-infected youth ≥5 years of age enrolled in a prospective cohort study, Pediatric AIDS Clinical Trials Group 219C, with ≥1 study visit before and after HIV disclosure. Age-specific quality-of-life instruments were completed by primary caregivers at routine study visits. The distribution of age at disclosure was summarized. Six quality-of-life domains were assessed, including general health perception, symptom distress, psychological status, health care utilization, physical functioning, and social/role functioning. For each domain, mixed-effects models were fit to estimate the effect of disclosure on quality of life.
RESULTS. A total of 395 children with 2423 study visits were analyzed (1317 predisclosure visits and 1106 postdisclosure visits). The median age at disclosure was estimated to be 11 years. Older age at disclosure was associated with earlier year of birth. Mean domain scores were not significantly different at the last undisclosed visit compared with the first disclosed visit, with the exception of general health perception. When all of the visits were considered, 5 of 6 mean domain scores were lower after disclosure, although the differences were not significant. In mixed-effects models, disclosure did not significantly impact quality of life for any domain.
CONCLUSIONS. Age at disclosure decreased significantly over time. There were no statistically significant differences between predisclosure and postdisclosure quality of life; therefore, disclosure should be encouraged at an appropriate time.},
	Author = {Butler, Anne M. and Williams, Paige L. and Howland, Lois C. and Storm, Deborah and Hutton, Nancy and Seage, George R.},
	Date-Added = {2017-12-19 03:48:36 +0000},
	Date-Modified = {2017-12-22 12:19:01 +0000},
	Doi = {10.1542/peds.2008-1290},
	Journal = {Pediatrics},
	Number = {3},
	Pages = {935--943},
	Title = {Impact of disclosure of {HIV} Infection on health-related quality of life among children and adolescents with {HIV} infection},
	Volume = {123},
	Year = {2009},
	Bdsk-Url-1 = {http://pediatrics.aappublications.org.proxy.lib.duke.edu/content/123/3/935},
	Bdsk-Url-2 = {https://dx.doi.org/10.1542/peds.2008-1290}}

@article{ajzen:1991,
	Author = {Ajzen, Icek},
	Date-Added = {2017-12-19 03:36:04 +0000},
	Date-Modified = {2017-12-19 03:37:19 +0000},
	Journal = {Organizational Behavior and Human Decision Proccesses},
	Number = {2},
	Pages = {179--211},
	Title = {The theory of planned behavior},
	Volume = {50},
	Year = {1991}}

@article{vreeman:2014,
	Abstract = {IntroductionDisclosure of HIV status to children is essential for disease management but is not well characterized in resource-limited settings. This study aimed to describe the prevalence of disclosure and associated factors among a cohort of HIV-infected children and adolescents in Kenya.MethodsWe conducted a cross-sectional study, randomly sampling HIV-infected children ages 6--14 years attending 4 HIV clinics in western Kenya. Data were collected from questionnaires administered by clinicians to children and their caregivers, supplemented with chart review. Descriptive statistics and disclosure prevalence were calculated. Univariate analyses and multivariate logistic regression were performed to assess the association between disclosure and key child-level demographic, clinical and psychosocial characteristics.ResultsAmong 792 caregiver-child dyads, mean age of the children was 9.7 years (SD = 2.6) and 51\% were female. Prevalence of disclosure was 26\% and varied significantly by age; while 62\% of 14-year-olds knew their status, only 42\% of 11-year-olds and 21\% of 8-year-olds knew. In multivariate regression, older age (OR 1.49, 95\%CI 1.35--1.63), taking antiretroviral drugs (OR 2.27, 95\%CI 1.29--3.97), and caregiver-reported depression symptoms (OR 2.63, 95\%CI 1.12--6.20) were significantly associated with knowing one's status. Treatment site was associated with disclosure for children attending one of the rural clinics compared to the urban clinic (OR 3.44, 95\%CI 1.75--6.76).ConclusionsFew HIV-infected children in Kenya know their HIV status. The likelihood of disclosure is associated with clinical and psychosocial factors. More data are needed on the process of disclosure and its impact on children.},
	Author = {Vreeman, Rachel C. and Scanlon, Michael L. and Mwangi, Ann and Turissini, Matthew and Ayaya, Samuel O. and Tenge, Constance and Nyandiko, Winstone M.},
	Date-Added = {2017-12-19 03:29:37 +0000},
	Date-Modified = {2017-12-22 12:25:57 +0000},
	Doi = {10.1371/journal.pone.0086616},
	Journal = {PLoS ONE},
	Month = jan,
	Number = {1},
	Pages = {e86616},
	Title = {A cross-sectional study of disclosure of {HIV} status to children and adolescents in {Western Kenya}},
	Volume = {9},
	Year = {2014},
	Bdsk-Url-1 = {http://dx.doi.org/10.1371/journal.pone.0086616}}

@article{kajubi:2014,
	Abstract = {Introduction
Knowledge of antiretroviral therapy (ART) among children with HIV depends on open communication with them about their health and medicines. Guidelines assign responsibility for communication to children's home caregivers. Other research suggests that communication is poor and knowledge about ART is low among children on treatment in low-income countries. This study sought to describe communication about medicine for HIV in quantitative terms from the perspectives of both children and caregivers. Thereafter, it established the factors associated with this communication and with children's knowledge about their HIV medicines.

Methods
We undertook a cross-sectional survey of a random sample of 394 children with HIV on treatment and their caregivers at nine health facilities in Jinja District, Uganda. We assessed reported frequency and content of communication regarding their medicines as well as knowledge of what the medicines were for. Logistic regression analysis was used to determine the factors associated with communication patterns and children's knowledge of HIV medicines.

Results
Although 79.6\% of the caregivers reported that they explained to the children about the medicines, only half (50.8\%) of the children said they knew that they were taking medicines for HIV. Older children aged 15--17 years were less likely to communicate with a caregiver about the HIV medicines in the preceding month (OR 0.5, 95\% CI 0.3--0.7, p=0.002). Children aged 11--14 years (OR 6.1, 95\% CI 2.8--13.7, p{\textless}0.001) and 15--17 years (OR 12.6, 95\% CI 4.6--34.3, p{\textless}0.001) were more likely to know they were taking medicines for HIV compared to the younger ones. The least common reported topic of discussion between children and caregivers was ``what the medicines are for'' while ``the time to take medicines'' was by far the most mentioned by children.

Conclusions
Communication about, and knowledge of, HIV medicines among children with HIV is low. Young age (less than 15 years) was associated with more frequent communication. Caregivers should be supported to communicate diagnosis and treatment to children with HIV. Age-sensitive guidelines about the nature and content of communication should be developed.},
	Author = {Kajubi, Phoebe and Whyte, Susan and Muhumuza, Simon and Kyaddondo, David and Katahoire, Anne R},
	Date-Added = {2017-12-19 03:19:51 +0000},
	Date-Modified = {2017-12-22 12:21:17 +0000},
	Doi = {10.7448/IAS.17.1.19012},
	Journal = {Journal of the International AIDS Society},
	Number = {1},
	Title = {Communication between {HIV-infected} children and their caregivers about {HIV} medicines: a cross-sectional study in {Jinja} district, {Uganda}},
	Volume = {17},
	Year = {2014},
	Bdsk-Url-1 = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087168/},
	Bdsk-Url-2 = {https://dx.doi.org/10.7448/IAS.17.1.19012}}

@article{cluver:2015,
	Author = {Cluver, Lucie D. and Hodes, Rebecca J. and Toska, Elona and Kidia, Khameer K. and Orkin, F. Mark and Sherr, Lorraine and Meinck, Franziska},
	Date-Added = {2017-12-19 03:19:51 +0000},
	Date-Modified = {2017-12-22 12:19:25 +0000},
	Journal = {AIDS},
	Pages = {S57--S65},
	Title = {{`HIV is like a tsotsi. ARVs are your guns'}: associations between HIV-disclosure and adherence to antiretroviral treatment among adolescents in {South Africa}},
	Volume = {29},
	Year = {2015},
	Bdsk-Url-1 = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00002030-201506001-00006},
	Bdsk-Url-2 = {https://dx.doi.org/10.1097/QAD.0000000000000695}}

@article{aderomilehin:2016,
	Author = {Aderomilehin, Oluyemisi and Hanciles-Amu, Angella and Ozoya, Oluwatobi Ohiole},
	Date-Added = {2017-12-19 03:19:51 +0000},
	Date-Modified = {2017-12-22 12:14:16 +0000},
	Journal = {Frontiers in Public Health},
	Number = {166},
	Title = {Perspectives and practice of {HIV} disclosure to children and adolescents by health-care providers and caregivers in sub-Saharan Africa: A Systematic Review},
	Volume = {4},
	Year = {2016},
	Bdsk-Url-1 = {http://journal.frontiersin.org/Article/10.3389/fpubh.2016.00166/abstract},
	Bdsk-Url-2 = {https://dx.doi.org/10.3389/fpubh.2016.00166}}

@article{turissini:2013,
	Abstract = {Background As antiretroviral therapy (ART) allows the world's 2.3 million human immunodeficiency virus (HIV)--infected children to grow and thrive, these children need to be informed of their HIV status. Neither the prevalence of disclosure to children nor its impact has been evaluated in most resource-limited settings.
Methods We conducted a prospective assessment of a random sample of HIV-infected children ages 6--14 years enrolled in HIV care at a large referral clinic in Eldoret, Kenya. Clinicians administered questionnaires to children and caregivers independently at routine clinic visits to assess disclosure status, ART adherence, stigma, and depression. Children's demographic and clinical characteristics were extracted from chart review. We calculated descriptive statistics and performed logistic regression to assess the association between disclosure and other characteristics.
Results Two hundred seventy children--caregiver dyads completed questionnaires. The mean child age was 9.3 years (standard deviation 2.6); 49\% were male, and 42\% were orphans. 11.1\% of children had been informed of their HIV status (N = 30). Of those under 10 years, 3.3\% knew their status, whereas 9.2\% of 10- to 12-year-olds and 39.5\% of 13- to 14-year-olds knew they had HIV. Only age was significantly associated with disclosure status in both bivariate analyses (P {\textless} .0001) and multiple logistic regression (odds ratio 1.67, 95\% confidence interval 1.36--2.05) when considering social demographics, disease stage variables, adherence, stigma measures, and depression.
Conclusions Rates of informing children in western Kenya of their HIV status are low, even among older children. Guiding families through developmentally appropriate disclosure processes should be a key facet of long-term pediatric HIV management.},
	Author = {Turissini, Matthew L. and Nyandiko, Winstone M. and Ayaya, Samuel O. and Marete, Irene and Mwangi, Ann and Chemboi, Victor and Warui, Lucy and Vreeman, Rachel C.},
	Date-Added = {2017-12-19 03:19:51 +0000},
	Date-Modified = {2017-12-22 12:24:31 +0000},
	Doi = {10.1093/jpids/pit024},
	Journal = {Journal of the Pediatric Infectious Diseases Society},
	Month = jun,
	Number = {2},
	Pages = {136--143},
	Title = {The prevalence of disclosure of {HIV} status to {HIV}-infected children in {Western Kenya}},
	Volume = {2},
	Year = {2013},
	Bdsk-Url-1 = {http://jpids.oxfordjournals.org/content/2/2/136},
	Bdsk-Url-2 = {https://dx.doi.org/10.1093/jpids/pit024}}

@incollection{ajzen:1985,
	Author = {Ajzen, Icek},
	Booktitle = {Action Control},
	Pages = {11--39},
	Publisher = {Springer},
	Title = {From intentions to actions: A theory of planned behavior},
	Year = {1985}}

@book{fishbein:2010,
	Author = {Fishbein, Martin and Ajzen, Icek},
	Publisher = {Taylor \& Francis},
	Title = {Predicting and changing behavior: The reasoned action approach},
	Year = {2010}}

@article{atwiine:2015,
	Abstract = {Highly active antiretroviral therapy has enabled HIV-infected children to survive into adolescence and adulthood, creating need for their own HIV diagnosis disclosure. Disclosure has numerous social and medical benefits for the child and family; however, disclosure rates tend to be low, especially in developing countries, and further understanding of the barriers is needed. This study describes the patterns and correlates of disclosure among HIV-infected children in southwestern Uganda. A cross-sectional study was conducted in a referral hospital pediatric HIV clinic between February and April 2012. Interviews were administered to caregivers of HIV-infected children aged 5-17 years. Data collected included socio-demographic characteristics of the child and caregiver, reported disclosure status, and caregivers' reasons for full disclosure or non-full disclosure of HIV status to their children. Bivariate and multivariate analysis was done to establish the socio-demographic correlates of disclosure. Caregivers provided data for 307 children; the median age was eight years (interquartile range [IQR] 7-11) and 52\% were males. Ninety-five (31\%) children had received full disclosure (48\% of whom were {\textgreater}12 years), 22 children (7\%) had received partial disclosure, 39 (13\%) misinformation, and 151 (49\%) no disclosure. Full disclosure was significantly more prevalent among the 9-11 and 12- to 17-year-olds compared to 5- to 8-year-olds (p-value {\textless} 0.001). The most frequently stated reason for disclosure was the hope that disclosure would improve medication adherence; the most frequently stated reason for nondisclosure was the belief that the child was too young to understand his/her illness. There was an inverse relationship between age and full disclosure and partial disclosure was rare across all age groups, suggesting a pattern of rapid, late disclosure. Disclosure programs should emphasize the importance of gradual disclosure, starting at younger ages, to maximize the benefits to the child and caregiver.},
	Author = {Atwiine, Barnabas and Kiwanuka, Julius and Musinguzi, Nicholas and Atwine, Daniel and Haberer, Jessica E.},
	Date-Added = {2017-12-19 03:19:51 +0000},
	Date-Modified = {2017-12-22 12:15:48 +0000},
	Doi = {10.1080/09540121.2014.978735},
	Journal = {AIDS Care},
	Number = {4},
	Pages = {424--430},
	Title = {Understanding the role of age in {HIV} disclosure rates and patterns for HIV-infected children in southwestern {Uganda}},
	Volume = {27},
	Year = {2015},
	Bdsk-Url-1 = {https://dx.doi.org/10.1080/09540121.2014.978735}}

@article{britto:2016,
	Author = {Britto, C. and Mehta, K. and Thomas, R. and Shet, A.},
	Date-Added = {2017-12-12 17:44:00 +0000},
	Date-Modified = {2017-12-22 12:17:42 +0000},
	Journal = {Journal of Developmental and Behavioral Pediatrics},
	Number = {6},
	Pages = {496-505},
	Title = {Prevalence and correlates of {HIV} disclosure among children and adolescents in low- and middle-income countries: A systematic review},
	Volume = {37},
	Year = {2016}}

@manual{survival-package,
	Author = {Terry M Therneau},
	Date-Added = {2017-11-30 23:01:58 +0000},
	Date-Modified = {2017-12-22 12:23:44 +0000},
	Note = {version 2.38},
	Title = {A package for survival analysis in {S}},
	Url = {https://CRAN.R-project.org/package=survival},
	Year = {2015},
	Bdsk-Url-1 = {https://CRAN.R-project.org/package=survival}}

@proceedings{brunette:2013,
	Author = {Brunette, Waylon and Sundt, Mitchell and Dell, Nicola and Chaudhri, Rohit and Breit, Nathan and Borriello, Gaetano},
	Booktitle = {{Proceedings of the 14th Workshop on Mobile Computing Systems and Applications}},
	Date-Added = {2017-11-30 19:59:42 +0000},
	Date-Modified = {2017-12-22 12:18:26 +0000},
	Title = {{Open Data Kit 2.0}: Expanding and refining information services for developing regions},
	Year = {2013}}

@misc{who:2011,
	Author = {WHO},
	Date-Added = {2017-11-29 21:20:50 +0000},
	Date-Modified = {2017-12-22 12:26:07 +0000},
	Title = {Guideline on {HIV} disclosure counselling for children up to 12 years of age},
	Url = {http://whqlibdoc. who.int/publications/2011/9789241502863_eng.pdf.},
	Year = {2011},
	Bdsk-Url-1 = {http://whqlibdoc.%20who.int/publications/2011/9789241502863_eng.pdf}}

@article{wiener:2007,
	Author = {Wiener, Lori and Mellins, Claude Ann and Marhefka, Stephanie and Battles, Haven B.},
	Date-Added = {2017-11-29 21:20:46 +0000},
	Date-Modified = {2017-12-22 12:26:18 +0000},
	Journal = {Journal of Developmental and Behavioral Pediatrics},
	Number = {2},
	Pages = {155},
	Title = {Disclosure of an {HIV} diagnosis to children: history, current research, and future directions},
	Url = {https://www.ncbi.nlm.nih.gov/pmc/articles/pmc2440688/},
	Volume = {28},
	Year = {2007},
	Bdsk-Url-1 = {https://www.ncbi.nlm.nih.gov/pmc/articles/pmc2440688/}}

@webpage{unaids:2017,
	Author = {UNAIDS},
	Date-Added = {2017-11-06 21:03:33 +0000},
	Date-Modified = {2017-11-06 21:17:06 +0000},
	Lastchecked = {November 6, 2017},
	Title = {AIDSinfo},
	Url = {www.aidsinfo.unaids.org},
	Year = {2017},
	Bdsk-Url-1 = {www.aidsinfo.unaids.org}}

@article{funck:1997,
	Abstract = {Objective: 
To investigate the patterns of disclosure and perceptions of human immunodeficiency virus (HIV) status in a group of HIV-infected elementary school---age children.Design:
A survey.Setting:
A referred care university hospital center.Patients:
All HIV-infected children born before August 31, 1985, and scheduled for ambulatory follow-up between 1984 and 1993 were eligible for the study. A total of 35 HIV-infected (21 asymptomatic and 14 symptomatic) elementary school---age children (aged 5-10 years) were examined between 1990 and 1993.Main Outcome Measures:
Semistructured qualitative interviews were used, 1 with the children and 1 with their parents or caregivers. In addition, 3 drawings per child were also analyzed.Results:
Partial disclosure was observed in 14 (40\%) of the children, and full disclosure of the diagnosis of acquired immunodeficiency syndrome was given to 6 (17\%) of the children. Secrecy regarding serostatus was the strategy used by 15 (43\%) of the parents or caregivers involving either complete nondisclosure (n=8) or deception by means of attributing the symptoms to another condition, medical or other (n=7). Perceived health status and clinical status differed for 11 (31\%) of the children. Eight children did not identify any illness causality, and most of the others gave prelogical or concrete-logical explanations. Few children were aware of their parent's infection or disease.Conclusion:
Human immunodeficiency virus---infected elementary school---age children were exposed to various disclosure patterns regarding their HIV infection or disease, and most children (26/35 [74\%]) reported stressful experiences due to HIV regardless of the disclosure patterns.Arch Pediatr Adolesc Med. 1997;151:978-985},
	Author = {Funck-Brentano, I. and Costagliola, D. and Seibel, N. and Straub, E. and Tardieu, M. and Blanche, S.},
	Date-Added = {2017-10-20 18:04:19 +0000},
	Date-Modified = {2017-12-22 12:20:15 +0000},
	Journal = {Archives of Pediatrics \& Adolescent Medicine},
	Number = {10},
	Pages = {978--985},
	Title = {Patterns of disclosure and perceptions of the human immunodeficiency virus in infected elementary school-age children},
	Volume = {151},
	Year = {1997},
	Bdsk-Url-1 = {http://dx.doi.org/10.1001/archpedi.1997.02170470012002}}

@article{pinzon:2013,
	Abstract = {Since the introduction of highly active antiretroviral therapy (ART) in 1996, HIV-infected children often survive beyond adolescence. To assess worldwide trends in disclosure since ART was introduced, we reviewed articles that refer to disclosure of their status to HIV-infected children, and which described patient, health care provider and/or caregiver opinions about disclosure and/or reported the proportion of children who knew their diagnosis. Most studies (17 [55\%]) were performed in low- or middle-income (LMI) countries. In the 21 articles that included information on whether the children knew their status, the proportion who knew ranged from 1.2 to 75.0\% and was lower in LMI (median = 20.4\%) than industrialized countries (43\%; p = 0.04). LMI country study participants who knew their status tended to have learned it at older ages (median = 9.6 years) than industrialized country participants (median = 8.3 years; p = 0.09). The most commonly reported anticipated risks (i.e. emotional trauma to child and child divulging status to others) and benefits (i.e. improved ART adherence) of disclosure did not vary by the country's economic development. Only one article described and evaluated a disclosure process. Despite recommendations, most HIV-infected children worldwide do not know their status. Disclosure strategies addressing caregiver concerns are urgently needed.},
	Author = {Pinz{\'o}n-Iregui, Mar{\'\i}a C. and Beck-Sagu{\'e}, Consuelo M. and Malow, Robert M.},
	Date-Added = {2017-10-20 17:59:48 +0000},
	Date-Modified = {2017-12-22 12:23:01 +0000},
	Journal = {Journal of Tropical Pediatrics},
	Number = {2},
	Pages = {84--89},
	Title = {Disclosure of their {HIV} status to infected children: A review of the literature},
	Volume = {59},
	Year = {2013},
	Bdsk-Url-1 = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693505/},
	Bdsk-Url-2 = {http://dx.doi.org/10.1093/tropej/fms052}}

@manual{R:2016,
	Address = {Vienna, Austria},
	Author = {{R Core Team}},
	Date-Added = {2017-10-18 15:53:04 +0000},
	Date-Modified = {2017-12-22 12:23:09 +0000},
	Organization = {{R Foundation for Statistical Computing}},
	Title = {R: A language and environment for statistical computing},
	Url = {https://www.R-project.org},
	Year = {2016},
	Bdsk-Url-1 = {https://www.R-project.org}}

@misc{unaids:2014,
	Author = {UNAIDS},
	Date-Added = {2017-10-10 18:12:03 +0000},
	Date-Modified = {2017-12-22 12:24:50 +0000},
	Title = {Zimbabwe developing subnational estimates of {HIV} prevalence and the number of people living with {HIV}},
	Year = {2014}}

@article{larmarange:2014,
	Author = {Larmarange, Joseph and Bendaud, Victoria},
	Date-Added = {2017-10-10 18:11:42 +0000},
	Date-Modified = {2017-10-10 18:11:56 +0000},
	Journal = {AIDS},
	Number = {Suppl 4},
	Pages = {S469--S476},
	Title = {HIV estimates at second subnational level from national population-based surveys},
	Volume = {28},
	Year = {2014}}

@article{bibace:1980,
	Author = {Bibace, Roger and Walsh, Mary E.},
	Date-Added = {2017-10-09 19:30:23 +0000},
	Date-Modified = {2017-10-09 19:30:46 +0000},
	Journal = {Pediatrics},
	Number = {6},
	Pages = {912--917},
	Title = {Development of children's concepts of illness},
	Volume = {66},
	Year = {1980},
	Bdsk-Url-1 = {http://pediatrics.aappublications.org/content/66/6/912.short}}

@article{blasini:2004,
	Abstract = {The American Academy of Pediatrics strongly encourages the disclosure of HIV status to school-age children and further recommends that adolescents know their HIV status. Limited information exists on the impact of disclosure. We designed and implemented a disclosure model hypothesized to be associated with healthy psychological adjustment and improved medication adherence. We report the model's design and implementation and results of a quasi-experimental study of the disclosure's effects on health care professionals (n = 16), caregivers (n = 39), and HIV-infected youth (n = 40) in Puerto Rico. Information was collected from youth, caregivers, and professionals by semistructured interviews and questionnaires. Most youth (70\%) had feelings of normalcy 6 months post-disclosure, and most also improved their adherence to therapy after disclosure as reported by both patients (58\%) and caregivers (59\%). Eighty-five percent of youth and 97\% of caregivers considered disclosure a positive event for themselves and their families. Fewer health care professionals reported feelings of fear, discomfort, and insecurity after protocol participation.},
	Author = {Blasini, Ileana and Chantry, Caroline and Cruz, Catherine and Ortiz, Laura and Salabarr{\'\i}a, Iraida and Scalley, Nydia and Matos, Beatriz and Febo, Irma and D{\'\i}az, Clemente},
	Date-Modified = {2017-12-22 12:16:11 +0000},
	Journal = {Journal of Developmental and Behavioral Pediatrics},
	Number = {3},
	Pages = {181--189},
	Title = {Disclosure model for pediatric patients living with {HIV} in {Puerto Rico}: design, implementation, and evaluation},
	Volume = {25},
	Year = {2004},
	Bdsk-Url-1 = {http://www.ncbi.nlm.nih.gov/pubmed/15194903}}

@article{lesch:2007,
	Author = {Lesch, A. and Swartz, L. and Kagee, A. and Moodley, K. and Kafaar, Z. and Myer, L. and Cotton, M.},
	Date-Modified = {2017-12-22 12:22:07 +0000},
	Journal = {AIDS Care},
	Number = {6},
	Pages = {811--816},
	Title = {Paediatric {HIV/AIDS} disclosure: towards a developmental and process-oriented approach},
	Volume = {19},
	Year = {2007}}

@book{tasker:1992,
	Author = {Tasker, Mary},
	Date-Modified = {2017-12-22 12:23:26 +0000},
	Publisher = {Association for the Care of Children's Health},
	Title = {{How Can I Tell You? Secrecy and Disclosure with Children When a Family Member has AIDS}},
	Year = {1992}}

@article{vreeman:2013,
	Author = {Vreeman, Rachel C and Gramelspacher, Anna Maria and Gisore, Peter O and Scanlon, Michael L and Nyandiko, Winstone M},
	Date-Modified = {2017-12-22 12:25:25 +0000},
	Journal = {Journal of the International AIDS Society},
	Number = {1},
	Title = {Disclosure of {HIV} status to children in resource-limited settings: a systematic review},
	Volume = {16},
	Year = {2013},
	Bdsk-Url-1 = {http://www.jiasociety.org/index.php/jias/article/view/18466},
	Bdsk-Url-2 = {http://dx.doi.org/10.7448/IAS.16.1.18466}}

@article{jemmott:2013,
	Abstract = {When children know their HIV serostatus, they are more likely to cooperate with steps to manage their health and the risk of transmitting HIV to others. Mounting evidence indicates that caregivers often do not disclose to HIV-positive children that the children are living with HIV, but little is known about the modifiable determinants of pediatric HIV disclosure. The present study examined theory-of-planned-behavior predictors of the intention to disclose to children their HIV diagnosis. The participants were 100 caregivers of HIV-positive children in Eastern Cape Province, South Africa. Proportional-odds logistic regression analysis revealed that normative support for disclosure and caregiver-child communication predicted the intention to disclose, whereas behavioral beliefs regarding the consequences of disclosing and self-efficacy to disclose did not. The results suggest that interventions to increase pediatric HIV disclosure in South Africa should help caregivers enlist support for disclosure among important referents and improve communication with their HIV-infected children.},
	Author = {Jemmott III, John B. and Heeren, G. Anita and Sidloyi, Lulama and Marange, C. Show and Tyler, Joanne C. and Ngwane, Zolani},
	Date-Modified = {2017-12-22 12:20:49 +0000},
	Doi = {10.1007/s10461-013-0672-0},
	Journal = {AIDS and Behavior},
	Number = {6},
	Pages = {1027--1036},
	Title = {Caregivers' intentions to disclose {HIV} diagnosis to children living with {HIV} in {South Africa}: A theory-based approach},
	Volume = {18},
	Year = {2013},
	Bdsk-Url-1 = {http://link.springer.com/article/10.1007/s10461-013-0672-0},
	Bdsk-Url-2 = {http://dx.doi.org/10.1007/s10461-013-0672-0}}

@article{binagwaho:2013,
	Abstract = {As the number of treatment-managed cases of pediatric Human
Immunodeficiency Virus (HIV) increases, the issue of disclosure has
become increasingly important. In this article, we evaluate factors
associated with disclosure in Rwanda among HIV-positive children of 7
to 15 years. A 2008 survey in Rwanda was conducted to determine these
factors. Participants in the study included 1,034 children on HAART and
in the pre-HAART phase; among them 65\% knew their HIV status, and 35\%
were unaware. The child's age was positively associated with
awareness of HIV status. Children with illiterate parents were two
times (aOR: 2.2; 95\% CI: 1.4-3.6) more likely to be disclosed than
children with high school educated parents. Children who engaged in
dialogue with their parents or other family members were 15 times and
four times, respectively, (aOR: 15.2, 95\% CI: 9.4- 24.7 and aOR: 4.1,
95\% CI: 2.4-6.9) more likely to be disclosed than those who did not.
Findings offer ways for Rwanda to improve its approach to disclosure
issues, counseling and psychosocial support for HIV-positive children.},
	Author = {Binagwaho, A. and Murekatete, I. and Rukundo, A. and Mugwaneza, P. and Hinda, R. and Lyambabaje, A. and Bizimana, Jd and Wagner, Cm and Muriisa, G. and Muita, J. and Mutabaxi, V. and Nyemazi, J. P. and Nsanzimana, S. and Karema, C.},
	Date-Modified = {2017-12-22 12:13:54 +0000},
	Journal = {Rwanda Medical Journal},
	Number = {3},
	Title = {Factors associated with disclosure of {HIV} status among {HIV} positive children in {Rwanda}},
	Volume = {69},
	Year = {2013},
	Bdsk-Url-1 = {https://tspace.library.utoronto.ca/handle/1807/41200}}

@article{nichols:2017,
	Abstract = {Pediatric HIV remains a significant global health dilemma, especially in resource-constrained nations. As access to ART increases around the world, areas of concern in pediatric HIV treatment include age-appropriate disclosure of HIV status to children and development of adherence habits over time. This review was conducted to synthesize quantitative associations reported between disclosure and adherence among children living with HIV in resource-limited settings. An electronic database search of PubMed, MEDLINE and Cochrane returned 1348 results after removal of duplicates, 14 of which were found to meet inclusion criteria. Review of these reports showed conflicting results regarding the impact of disclosure on adherence, with 5 showing no association, 4 showing a negative impact of disclosure on adherence, and 5 showing positive benefits of disclosure for adherence habits. Thus, there was no clear consensus on the effect, if any, that disclosure has on medication adherence. Longitudinal, prospective research needs to be conducted to evaluate further impacts that disclosure may have on adherence habits over time, and interventions must be structured to link the two processes together in order to maximize health benefit to the child or adolescent.},
	Author = {Nichols, Justin and Steinmetz, Alexis and Elijah, Paintsil},
	Date-Modified = {2017-12-22 12:29:59 +0000},
	Doi = {10.1007/s10461-016-1481-z},
	Journal = {AIDS and Behavior},
	Month = jul,
	Number = {1},
	Pages = {1--11},
	Title = {Impact of {HIV-status} disclosure on adherence to antiretroviral therapy among {HIV-infected} children in resource-limited aettings: A systematic review},
	Volume = {21},
	Year = {2017},
	Bdsk-Url-1 = {http://link.springer.com/article/10.1007/s10461-016-1481-z},
	Bdsk-Url-2 = {http://dx.doi.org/10.1007/s10461-016-1481-z}}

@article{krauss:2016,
	Author = {Krauss, Beatrice J. and Letteney, Susan and Okoro, Chioma N.},
	Date-Modified = {2017-12-22 12:21:49 +0000},
	Journal = {Frontiers in Public Health},
	Title = {Why tell children: A synthesis of the global literature on reasons for disclosing or not disclosing an {HIV} diagnosis to children 12 and under},
	Volume = {4},
	Year = {2016},
	Bdsk-Url-1 = {http://journal.frontiersin.org/Article/10.3389/fpubh.2016.00181/abstract},
	Bdsk-Url-2 = {http://dx.doi.org/10.3389/fpubh.2016.00181}}

@article{allison:2015,
	Author = {Allison, Susannah M. and Siberry, George K.},
	Date-Modified = {2017-12-22 12:15:21 +0000},
	Journal = {AIDS},
	Number = {Suppl 1},
	Pages = {S109--S118},
	Title = {{National Institutes of Health} investment in studies of {HIV} disclosure to children},
	Volume = {29},
	Year = {2015},
	Bdsk-Url-1 = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00002030-201506001-00011},
	Bdsk-Url-2 = {http://dx.doi.org/10.1097/QAD.0000000000000663}}

@misc{unaids:2016,
	Author = {UNAIDS},
	Date-Modified = {2017-12-22 12:25:00 +0000},
	Title = {{Children and HIV: Fact sheet}},
	Year = {2016}}

@techreport{zdhs:2015,
	Author = {{Zimbabwe National Statistics Agency} and {ICF International}},
	Date-Modified = {2017-12-22 12:26:31 +0000},
	Title = {{Zimbabwe Demographic and Health Survey 2015: Final Report}},
	Year = {2016}}

@url{r2d2site,
	Author = {Green, Eric},
	Date-Added = {2017-12-22},
	Title = {Readiness to Disclose Pediatric {HIV} Status to Children},
	Url = {https://ericpgreen.github.io/r2d2/},
	Bdsk-Url-1 = {https://ericpgreen.github.io/r2d2/}}