Mental Health Challenges among Children and Adolescents Associated with HIV Status Disclosure: A Systematic Review and Meta-Analysis Protocol

BACKGROUND: Prenatally acquired HIV is highly prevalent among children and adolescents globally. HIV status disclosure to children is recommended to start from 8 years and older and has shown several benefits. However, HIV status disclosure is also associated with high risks of mental health challenges. This review and meta-analysis aim at describing the prevalence of mental health challenges and associated factors among children and adolescents living with HIV. METHODS: The study will involve conducting a systematic review and meta-analysis of the existing literature on the burden of mental health challenges, including stigma, depression, anxiety, and suicidality, after HIV status disclosure among children and adolescents aged 8-17 years. Searches for both observational and interventional studies will be performed in PubMed, Medline, Embase, CINAHL, and APA Psych Info from 2000 to the date of the review. Statistical heterogeneity will be assessed using the I2 test and visual inspection of the forest plot. Data will be extracted using an investigator-designed data extraction form by two independent people, and any disagreements will be resolved by involving a third person. Using the RevMan software, a random effects model will be applied to calculate a standardized mean estimate of the prevalence of mental health challenges. A narrative will be presented for the factors associated with the mental health challenges. Risk of bias will be assessed using the appropriate study design tool, and results will be reported following the PRISMA 2015 guidelines. CONCLUSION: The review will provide valuable results that will shed light on the burden of mental health challenges associated with HIV status disclosure and the influencing factors among children and adolescents. This will inform clinical practice about the importance of assessing and managing the challenges accordingly, as well as designing health policies regarding the same.