Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results

AIDS. 2015 Jun;29 Suppl 1(0 1):S91-8. doi: 10.1097/QAD.0000000000000665.


Objectives: To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic.

Design: A quasi-experimental trial was conducted comparing caregiver-youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth.

Methods: Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0-17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation.

Results: To date, 65 Dominican Republic and 27 Haiti caregiver-youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM.

Conclusion: Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM.

Publication types

  • Comparative Study
  • Editorial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anti-Retroviral Agents / therapeutic use
  • Caregivers / psychology
  • Child
  • Dominican Republic
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / psychology*
  • Haiti
  • Humans
  • Male
  • Models, Psychological*
  • Patient Satisfaction
  • Truth Disclosure*


  • Anti-Retroviral Agents