Eve S Puffer1,2, Amy Finnegan2, Katie Schenk3, Lisa Langhaug4, Simbarashe Rusakaniko5, Yujung Choi2, Simbarashe Mahaso6, Ryan Simmons2, Eric P Green2. 1. Department of Psychology and Neuroscience, Duke University, Durham, NC, USA. 2. Duke Global Health Institute, Duke University, Durham, NC, USA. 3. Department of Global and Community Health, George Mason University, Washington, DC, USA. 4. Regional Psychosocial Support Initiative, Harare, Zimbabwe. 5. Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe. 6. Batanai HIV & AIDS Service Organization, Masvingo, Zimbabwe.
Abstract
OBJECTIVE: We aimed to: (1) follow parents and guardians through the process of paediatric HIV disclosure to understand how often pre-disclosure worries are realised; and (2) estimate the effects of disclosure on child, caregiver, and family well-being. DESIGN: We conducted a 12-month prospective cohort study in Zimbabwe with 123 primary caregivers of children ages 9 to 15 years who were HIV positive but did not know their serostatus at baseline. By the end of the study period 65 caregivers reported that their child learned his or her HIV-positive status. MAIN OUTCOME MEASURES: We used three waves of data to compare caregivers' pre-disclosure worries to post-disclosure reports and to characterise associations between disclosure and well-being of the child (Strengths and Difficulties Questionnaire), caregiver (Patient Health Questionnaire-9), and family (Family Relationship Quality) over time. RESULTS: Caregivers' pre-disclosure worries and fears about how their child would react to disclosure of their HIV status largely went unrealised. Furthermore, we did not find strong evidence of clinically-important increases in problems on average following disclosure. CONCLUSION: Findings support the call to identify supportive intervention strategies that address caregiver fears at the beginning of the disclosure process.
OBJECTIVE: We aimed to: (1) follow parents and guardians through the process of paediatric HIV disclosure to understand how often pre-disclosure worries are realised; and (2) estimate the effects of disclosure on child, caregiver, and family well-being. DESIGN: We conducted a 12-month prospective cohort study in Zimbabwe with 123 primary caregivers of children ages 9 to 15 years who were HIV positive but did not know their serostatus at baseline. By the end of the study period 65 caregivers reported that their child learned his or her HIV-positive status. MAIN OUTCOME MEASURES: We used three waves of data to compare caregivers' pre-disclosure worries to post-disclosure reports and to characterise associations between disclosure and well-being of the child (Strengths and Difficulties Questionnaire), caregiver (Patient Health Questionnaire-9), and family (Family Relationship Quality) over time. RESULTS: Caregivers' pre-disclosure worries and fears about how their child would react to disclosure of their HIV status largely went unrealised. Furthermore, we did not find strong evidence of clinically-important increases in problems on average following disclosure. CONCLUSION: Findings support the call to identify supportive intervention strategies that address caregiver fears at the beginning of the disclosure process.
Authors: A C Gerson; M Joyner; P Fosarelli; A Butz; L Wissow; S Lee; P Marks; N Hutton Journal: J Pediatr Health Care Date: 2001 Jul-Aug Impact factor: 1.812
Authors: Rachel C Vreeman; Anna Maria Gramelspacher; Peter O Gisore; Michael L Scanlon; Winstone M Nyandiko Journal: J Int AIDS Soc Date: 2013-05-27 Impact factor: 5.396