Tamsen J Rochat1, Adriane X Arteche, Alan Stein, Ntombizodumo Mkwanazi, Ruth M Bland. 1. aAfrica Centre for Health and Population Studies, University of KwaZulu-Natal bDepartment of Psychology, Stellenbosch University, South Africa cDepartment of Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil dSection of Child and Adolescent Psychiatry, Department of Psychiatry, Oxford University, Oxford, UK eSchool of Public Health, University of Witwatersrand, Johannesburg fAfrica Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba gSchool of Public Health, University of Witwatersrand, Johannesburg hAfrica Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa iRoyal Hospital for Sick Children, University of Glasgow, Glasgow, UK jSchool of Public Health, University of Witwatersrand, Johannesburg, South Africa.
Abstract
OBJECTIVES: Sub-Saharan Africa has large populations of HIV-infected parents who need support to raise their HIV-uninfected children. This research evaluates the 'Amagugu Intervention' aimed at supporting mothers to disclose their own HIV diagnosis to their HIV-uninfected children. DESIGN: Uncontrolled pre and post-intervention evaluation. SETTING: Africa Centre for Health and Population Studies, South Africa. PARTICIPANTS: Two hundred and eighty-one HIV-infected women and their HIV-uninfected children aged 6-10 years. INTERVENTION: This lay counsellor-led intervention included six sessions conducted with mothers at home, providing printed materials and child-friendly activities to support disclosure of their diagnosis. MAIN OUTCOME MEASURE: The primary outcome was disclosure to the child (full, partial, none). The secondary outcomes included maternal mental health (General Health Questionnaire) and child mental health (Child Behaviour Checklist). RESULTS: One hundred and seventy-one (60%) women 'fully' disclosed and 110 (40%) women 'partially' disclosed their HIV status to their child. Women who perceived their health to be excellent were less likely to 'fully' disclose compared to those considering their health to be poorer [adjusted odds ratio 0.50 (0.26-0.98), P = 0.042]. [corrected]. Compared to those not in a current partnership, those with a current partner were almost three times more likely to 'fully' disclose [adjusted odds ratio 2.92 (1.33-6.40), P = 0.008]. Mothers reported that most children reacted calmly to 'full' (79%) or 'partial' disclosure (83%). Compared to 'partial' disclosure, 'full' disclosure was associated with more children asking questions about maternal death (18 versus 8%). CONCLUSIONS: This intervention is acceptable in resource-limited settings and shows promise. Further research using a controlled design is needed to test this intervention.
OBJECTIVES: Sub-Saharan Africa has large populations of HIV-infected parents who need support to raise their HIV-uninfectedchildren. This research evaluates the 'Amagugu Intervention' aimed at supporting mothers to disclose their own HIV diagnosis to their HIV-uninfectedchildren. DESIGN: Uncontrolled pre and post-intervention evaluation. SETTING: Africa Centre for Health and Population Studies, South Africa. PARTICIPANTS: Two hundred and eighty-one HIV-infectedwomen and their HIV-uninfectedchildren aged 6-10 years. INTERVENTION: This lay counsellor-led intervention included six sessions conducted with mothers at home, providing printed materials and child-friendly activities to support disclosure of their diagnosis. MAIN OUTCOME MEASURE: The primary outcome was disclosure to the child (full, partial, none). The secondary outcomes included maternal mental health (General Health Questionnaire) and child mental health (Child Behaviour Checklist). RESULTS: One hundred and seventy-one (60%) women 'fully' disclosed and 110 (40%) women 'partially' disclosed their HIV status to their child. Women who perceived their health to be excellent were less likely to 'fully' disclose compared to those considering their health to be poorer [adjusted odds ratio 0.50 (0.26-0.98), P = 0.042]. [corrected]. Compared to those not in a current partnership, those with a current partner were almost three times more likely to 'fully' disclose [adjusted odds ratio 2.92 (1.33-6.40), P = 0.008]. Mothers reported that most children reacted calmly to 'full' (79%) or 'partial' disclosure (83%). Compared to 'partial' disclosure, 'full' disclosure was associated with more children asking questions about maternal death (18 versus 8%). CONCLUSIONS: This intervention is acceptable in resource-limited settings and shows promise. Further research using a controlled design is needed to test this intervention.
Authors: Charles Peter Osingada; Monica Okuga; Rose Chalo Nabirye; Nelson Kaulukusi Sewankambo; Damalie Nakanjako Journal: BMC Public Health Date: 2016-07-11 Impact factor: 3.295
Authors: Sumona Chaudhury; Catherine M Kirk; Charles Ingabire; Sylvere Mukunzi; Beatha Nyirandagijimana; Kalisa Godfrey; Robert T Brennan; Theresa S Betancourt Journal: Front Public Health Date: 2016-06-29