Videos used in the HADITHI study helped children understand why they need to take medicines to keep themselves healthy.
In July, 2025, the World Health Organization (WHO) released a new publication highlighting key research that will help health care providers tell children and adolescents that they have HIV.
In this Q&A, Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health at Mount Sinai, explains how research conducted through AMPATH Kenya contributed to the development of the WHO’s new guidance.
“This is a great example of how our approach to research—prioritizing close, equitable collaboration with our Kenyan colleagues and centering the voices and needs of youth—results in best practices and can influence policy globally,” she said.
What is the AMPATH Kenya partnership, and what is the Institute’s role with it?
The AMPATH Kenya partnership is a strong collaboration among Moi University and Moi Teaching and Referral Hospital in Eldoret, Kenya, the Kenyan government, and a global consortium of universities that includes Mount Sinai. Within AMPATH Kenya, the Arnhold Institute supports and leads activities to improve youth health in Kenya, including clinical programs, research, and capacity-building for adolescent health.
Medications used to treat pediatric HIV. A major part of the disclosure process is helping children understand why they need to take medications every day.
What is the new World Health Organization guidance document?
The guidance released this year summarizes key research on ways to tell children and adolescents about their HIV status in a safe and empowering way, known in the pediatric HIV field as “disclosure.” The WHO document helps health care providers and HIV programs understand what has worked in different contexts. I’m proud to note that research from the AMPATH Kenya partnership—work testing a new disclosure program for children ages 10 to 15—was highlighted as one of those key studies. I was a lead author on that study, along with my Kenyan counterpart Dr. Winstone Nyandiko, Professor of Pediatrics and Child Health. Now, this program to support disclosure is not only recommended nationally for Kenya, but is also part of what the WHO recommends globally. In addition to this intervention program, the WHO also cited AMPATH Kenya’s qualitative research describing other HIV disclosure practices for children.
Tell us more about what makes your study unique.
We named our study the HADITHI intervention, which is short for “Helping AMPATH Disclose Information and Talk about HIV Infection.” Hadithi also means “story” in Kiswahili, the language most of our Kenyan patients speak, because stories were what the initiative was all about. There are a lot of stories that people tell about HIV, many of them stigmatizing. So when you tell someone that they have HIV, especially a child, you’re playing a role in how they understand their own life story—is it happy or sad, shameful or empowering? The framing is very important. In this counseling we did in the program, we also used stories told by Kenyans to help the children understand their HIV status in a culturally sensitive way.
One other important element of the HADITHI study was our use of peer support groups in helping patients learn about and accept their diagnosis. In fact, peer support for adolescents continues to be a cornerstone of Mount Sinai’s work in HIV in Kenya. In the WHO guidance document, peer support was specifically identified as a key feature of disclosure interventions in this age group.
Why is the way disclosure is conducted for children so important?
When a child is living with HIV, at some point—often when they’re quite young, six or so, but sometimes not until they’re adolescents—their families and doctors must start the process of telling them their diagnosis. Eventually, they need to understand why they have to take medicines every day for the rest of their lives. And, they need to get this information in a developmentally appropriate way that fits the child’s age. Often, they’ve already heard a lot of rumors and misinformation about people living with HIV, and may be afraid of being a person with HIV. The process of telling them must therefore be done very carefully, in a way that reassures them that they can still live a long, happy, productive life. That is the process of disclosure, and it can take months or years of preparation and gradual teaching.
It’s so important that disclosure is done well, especially because many children get HIV from their mothers. We need to protect the bond between the mother and the child and empower the child or adolescent to feel good about themselves and begin to accept responsibility for taking care of their own health.
What does it mean to the Arnhold Institute and to you personally that this research was cited by the WHO?
As a career researcher in Kenya and a passionate advocate for children and adolescents, I am immensely proud to have contributed to this work at a global level. We at the Arnhold Institute and AMPATH Kenya are truly doing innovative and impactful work for children, and as a pediatrician, I can’t think of anything more rewarding than that.
Rachel Vreeman, MD, MS is a pediatrician, Director of the Arnhold Institute for Global Health, and Professor and Chair of Global Health at the Icahn School of Medicine at Mount Sinai.