258754 Child, parent, and healthcare professionals' perspectives on HIV infection status disclosure to children

Tuesday, October 30, 2012

Grace Gachanja, RN, MPH, PhD , College of Health Sciences, Walden University, Minneapolis, MN
Gary J. Burkholder, PhD , Senior Research Scholar, Center for Research Support, Walden University, Minneapolis, MN
Aimee Ferraro, PhD, MPH , College of Health Sciences, Walden University, Minneapolis, MN
Background: HIV disclosure is a challenging process for parents and healthcare professionals. The majority of HIV-infected persons live in Sub-Saharan Africa where HIV disclosure guidelines for a parent's and a child's illness are nonexistent. While there are two theoretical models of HIV disclosure, their utility in explaining disclosure in African cultures is largely unknown. Methods: This qualitative phenomenological study was conducted in Kenya to describe the lived experiences of HIV-positive parents and their children during the disclosure process. Thirty four participants consisting of 16 HIV-positive parents, 7 HIV-positive children, 5 HIV-negative children, and 6 healthcare professionals were engaged in in-depth, semistructured interviews. Interview data were analyzed using the modified Van Kaam method. Results: HIV disclosure is a complex process involving factors such as a parent's and child's state of health, ART consumption, stigma/discrimination, and sexuality concerns. Parents take years to prepare for and perform disclosure of theirs and/or their children's illnesses to their infected and noninfected children. They perform disclosure when they feel ready in stages, based on the birth order of their children, the perception of “the right time,” the child's understanding and maturity level, and whose illness(es) they intend to disclose at the time of disclosure. Conclusion: HIV disclosure is challenging and each disclosure session performed is planned and geared to the particular child receiving disclosure. Parents and healthcare professionals are challenged by disclosure and can benefit from creation of HIV disclosure guidelines accompanied by culturally sensitive manuals and training programs aimed at parents and healthcare professionals to ease the process of disclosure.

Learning Areas:
Chronic disease management and prevention
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the lived experiences of HIV positive parents as they go through the process of disclosing a parent's and/or a child's HIV infection status to their infected and noninfected children.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal researcher for this study on HIV disclosure from parent to child. My research interests include HIV prevention and control strategies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.