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Aurpibul L, Tangmunkongvorakul A, Detsakunathiwatchara C, Masurin S, Srita A, Meeart P, Chueakong W. Social effects of HIV disclosure, an ongoing challenge in young adults living with perinatal HIV: a qualitative study. Front Public Health 2023; 11:1150419. [PMID: 37275489 PMCID: PMC10235696 DOI: 10.3389/fpubh.2023.1150419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Young adults with perinatal HIV (YAPHIV) have survived the long journey of life while living with HIV since early childhood. We explore the HIV disclosure experience and its social effects from their perspectives. Methods The qualitative study was conducted from June to November 2022 in Chiang Mai, Thailand. Data were collected through individual in-depth semi-structured interviews with 20 YAPHIV at the median age of 25 years. Content analysis was used to identify themes from the interview transcripts. Results Most participants learned their HIV status from their parents, caregivers, healthcare providers, or other people in community during their childhood. Some were disclosed later in adolescent years. HIV disclosure to others was associated with various experiences in different stages of life. While some YAPHIV decided not to disclose their HIV status to anyone, it also had social effects. Three major themes were identified: (1) positive social effects of HIV disclosure (perceived social acceptance, perceived social support); (2) negative social effects of HIV disclosure (effects on child rearing, schooling, and family relationship); and (3) HIV non-disclosure (anticipated stigma, negative effects on the quality of employment, and relationships). An emerging theme was a need for peer support mentioned by several YAPHIV as they would like to discuss with somebody and share their feelings while living with HIV. Conclusion HIV disclosure remains challenging for YAPHIV while growing up and moving toward adult milestones. Better understanding their situations and perspectives would allow healthcare providers to provide them with updated HIV knowledge, coping skills, and psychosocial support.
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Warburton K, Navér L, Houghton J, Fatikhova K. Talking to children about their HIV diagnosis: a discussion rooted in different global perspectives. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S4-S9. [PMID: 35019738 DOI: 10.12968/bjon.2022.31.1.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
An online meeting was arranged with four professionals representing four countries to debate current practices and future steps in naming HIV to children (disclosing HIV status). This article considers the evidence and reports on the commentary and debate from the meeting. Naming HIV to children remains a challenge. Although studies identify some of the facilitators and barriers to informing children of their HIV diagnosis, further review of practice is required. This article presents a global perspective of naming practices from different settings. The article comprises commentary and a report of the online debate, along with supporting evidence. The four participating authors concluded that health professionals must work in collaboration with families to support early naming of HIV to children or having an open discussion about HIV in clinics. Naming when a child is younger reduces self-stigma and empowers children and young people to adhere to their medication, make informed decisions and share their own diagnosis appropriately. The authors concluded that health professionals play a key role in educating colleagues and the public to reduce stigma and discrimination. Professionals working with children and families living with HIV require support and resources to instil confidence in naming and facilitate naming of HIV status to a child.
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Affiliation(s)
- Katie Warburton
- Senior Lecturer in Children and Young People's Nursing, University of Central Lancashire
| | - Lars Navér
- Consultant Paediatrician, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, and the Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Kamila Fatikhova
- Co-ordinator of Daycare Centre for Children and Families Affected by HIV, Tashkent, Uzbekistan
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Cremonese L, de Mello Padoin SM, de Paula CC. Communication of HIV diagnosis in proper time: scoping review. Rev Esc Enferm USP 2021; 55:e20210153. [PMID: 34730609 DOI: 10.1590/1980-220x-reeusp-2021-0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To map how the communication of the HIV infection diagnosis occurs in pediatrics. METHODS Scoping review of the 64 original articles. We selected research papers in Portuguese, English, or Spanish, with the participants: child, adolescent, relative/family, and/or health professional from 2011-2020. We accessed the following sources: PubMed, CINAHL, Scopus, WoS, ASSIA, PsycINFO, ERIC, Sociological Abstracts, Edubase, LILACS, BDENF, and IndexPsi. RESULTS Regarding the population, it was evident to us that the relative must be the sender of the diagnosis with the professionals' support; regarding the reasons for the communication, the child maturity, expressed by questions, the necessity of therapy adherence, abilities to communicate and the right of knowing the diagnosis must be considered. The communication channel is centered on materials that promote comprehension, quantity, and quality of information. That indicated an interactive process. Regarding the effects, they are beneficial when the communication occurs at a proper time. CONCLUSION Communication must occur through a process that includes professional support to the relatives/family, development of abilities to evaluate the appropriate moment, and the monitoring effect.
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Affiliation(s)
- Luiza Cremonese
- Universidade Luterana do Brasil, Cachoeira do Sul, RS, Brazil
| | | | - Cristiane Cardoso de Paula
- Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.,Centro Brasileiro para o Cuidado à Saúde Baseado em Evidências: Centro de Excelência do JBI. (JBI Brazil) São Paulo, SP, Brazil
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de Moura Bubadué R, Cabral IE. Advocacy care on HIV disclosure to children. Nurs Inq 2018; 26:e12278. [PMID: 30565379 DOI: 10.1111/nin.12278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 10/12/2018] [Accepted: 10/23/2018] [Indexed: 12/01/2022]
Abstract
Children with HIV are dependent on taking continuous medication and care, and family preparation is required when disclosing HIV. This study aimed to unveil families' experiences with HIV disclosure to children under 13 years old. Eight family members who have disclosed HIV to seropositive children were interviewed in-depth and individually. The fieldwork took place at a public paediatric outpatient hospital in Rio de Janeiro. The results showed that the family members' discourse highlighted two ways of knowing their own condition and disclosing the condition of the children with HIV. First, they needed to address the communication of bad news and discover their own HIV status through their children's disease. Second, the disclosure was a process constituted by four stages: preparing for disclosure, identifying the time, deciding how and where to tell, and instilling silence after disclosure. They also recognized that nurses had a role in the process as part of an interprofessional team. Nurses can develop advocacy care and empower family members in the preparation of safe HIV disclosure. By systematizing and institutionalizing the care advocacy process, nurses may enable caretakers and children to participate in their therapeutic management, improving adherence to the treatment and self-care with autonomy.
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DeSilva MB, Penwill N, Sabin L, Gifford AL, Li Z, Fujie Z, Weiwei M, Yongzhen L, Hongyan L, Xuemei Z, Barnoon Y, Gill CJ, Bonawitz R. We don't dare to tell her … we don't know where to begin: Disclosure experiences and challenges among adolescents living with HIV and their caregivers in China. Int J Pediatr Adolesc Med 2018; 5:5-12. [PMID: 30805525 PMCID: PMC6363272 DOI: 10.1016/j.ijpam.2017.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES With increasing access to antiretroviral therapy, HIV-infected youth are living longer, but are vulnerable as they navigate the transition to adulthood while managing a highly stigmatized condition. Knowing one's HIV status is critical to assuming responsibility for one's health. The process of disclosure to adolescents living with HIV is not well understood globally, even less so in China. To help address this gap, we explored practices for disclosure to adolescents living with HIV (ALHIV) among Chinese caregivers and clinicians, and the disclosure experiences of the adolescents themselves using qualitative methods. DESIGN AND SETTING The study was conducted in 2014 at the Guangxi Center for Disease Control and Prevention ART (CDC-ART) clinic in Nanning, China. We used a qualitative design, incorporating in-depth interviews (IDIs) and focus group discussions (FGDs). PATIENTS AND METHODS We conducted IDIs with 19 adolescent/caregiver dyads and five FGDs with adolescents and clinicians. Adolescent participants were aged 10-15 years, and had contracted HIV perinatally. Using NVivoTM software, we summarized major themes. RESULTS Only 6/19 caregivers reported disclosing to their child; matched adolescents' statements indicate that 9/19 children knew their HIV status. Caregivers planned to disclose when children were 14 years or older. Concerns about stigma toward children and families were associated with reluctance to disclose. CONCLUSION Disclosure to adolescents living with HIV in China was delayed compared with recommended guidelines. Culturally appropriate disclosure strategies should be developed, focused on supporting caregivers and de-stigmatizing HIV.
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Affiliation(s)
- Mary Bachman DeSilva
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA, United States
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States
- Westbrook College of Health Professions, University of New England, Portland, ME, United States
| | - Nicole Penwill
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA, United States
| | - Lora Sabin
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA, United States
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States
| | - Allen L. Gifford
- Departments of Health Policy and Management, Boston University Schools of Public Health and Medicine, Boston University, Boston, MA, United States
- Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, United States
| | | | - Zhang Fujie
- Division of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Mu Weiwei
- Division of Treatment and Care, National Center for AIDS/STD Control and Prevention (NCAIDS), China CDC, Beijing, China
| | - Li Yongzhen
- AIDS Division, Guangxi Centers for Disease Control and Prevention, Guangxi, China
| | - Lu Hongyan
- AIDS Division, Guangxi Centers for Disease Control and Prevention, Guangxi, China
| | - Zeng Xuemei
- AIDS Division, Guangxi Centers for Disease Control and Prevention, Guangxi, China
| | - Yiyao Barnoon
- Boston Children's Hospital, 300 Longwood Ave., Boston, MA, United States
| | - Christopher J. Gill
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA, United States
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States
| | - Rachael Bonawitz
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA, United States
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States
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