Conclusion
depression
Our study found that caregiver isolation status and the length of time a child had been on antiretroviral therapy were predictive of disclosure of HIV status to children living with HIV in western Kenya after participation in a disclosure intervention. We also found that children who had their HIV status disclosed to them and those who did not had no statistically significant different outcomes in CD4 percentage, depression status, or mental and emotional status up to 24 months post-intervention. The results of this study can inform future adaptation of the HADITHI intervention as well as disclosure interventions in other low-resource contexts. Disclosure interventions should integrate additional mental health and treatment adherence counseling aimed at continuing to stabilize mental health post-disclosure and improving mental health and HIV outcomes over time. Educational components of disclosure interventions can also be tailored to include concepts related to HIV-related stigma and caregiver and family isolation and target new ARV patients. Future research should replicate this study design elsewhere to understand factors contributing to disclosure compliance in other settings and further explore the impact of disclosure on health outcomes at further timepoints post-disclosure.