142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Parents' and children's emotions spanning the HIV disclosure process in Kenya

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Grace Gachanja, PhD, MPH, RN , College of Health Sciences, Walden University, Minneapolis, MN
Gary J. Burkholder, PhD , Senior Research Scholar, Center for Research Quality, Walden University, Minneapolis, MN
Aimee Ferraro, PhD, MPH , College of Health Sciences, Walden University, Minneapolis, MN
Background: HIV disclosure from parent to child is challenging. While disclosure is expected to be emotional for parents and children, the total disclosure experience has not been described. The purpose of this study was to understand the lived experiences of HIV-positive parents and their children in Kenya during the disclosure process.

Methods: Phenomenological qualitative data were collected using in-depth semistructured interviews. Thirty four participants consisting of HIV-positive parents, their children (infected and uninfected), and healthcare professionals (HCPs) were enrolled. Data analysis was performed using NVivo 8 and the Van Kaam method.

Results: Pre-disclosure, parents were plagued with fear/worry of stigma, judgment, rejection, blame; and the reaction/consequences of disclosure on their children. Guilt and shame for bringing the illness into the home abounded. Children sensed, wondered, and worried about secrets within their homes. During disclosure, parents experienced catharsis, guilt, confusion, and panic when children reacted negatively. Children experienced shock, disbelief, anger, sadness, worry, depression, confusion, and catharsis from finally knowing what was wrong. Post-disclosure parents alternated between relief, guilt, and depression as their children’s behavior changed due to disclosure. Children experienced unhappiness, depression, hopelessness, self-hate, and withdrawal. Recovery time varied lasting from a few hours to four months later; some children ultimately felt relief and self-acceptance. However, stress exposure caused disclosure emotions to reappear.

Conclusion: HIV disclosure process is accompanied by alternating negative and positive feelings for both parents and children. To ease the process, HCPs should provide support services such as disclosure practice sessions/trainings, counseling, peer support groups, and stress management.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the emotional feelings experienced by HIV-positive parents and their children during the HIV disclosure process

Keyword(s): HIV/AIDS, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the primary researcher who performed data collection and analysis of this study
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.