Abstract

There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIV-positive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIV-negative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak with for social support. When feeling overwhelmed by their circumstances, the children self-withdrew and performed positive activities (e.g., praying, watching TV, listening to the radio, singing, dancing) to help themselves feel better. Many HIV-affected families have a combination of HIV-positive and negative siblings within the household. Pending further studies conducted with larger sample sizes, the results of this study should assist healthcare professionals to better facilitate disclosure between HIV-positive parents and their children of mixed HIV statuses.

Highlights

  • HIV/AIDS remains a public health issue affecting 35.3 million persons globally (UNAIDS, 2013)

  • In 2012, the adult HIV prevalence was 6% (UNAIDS, 2013), and 5% of Kenyan homes had a HIV-positive head of household (National AIDS and STI Control Programme Kenya, 2014)

  • Recruitment of participants Data collection for the larger study was conducted in December 2010 through January 2011 at the Kenyatta National Hospital Comprehensive Care Center located in Nairobi, Kenya

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Summary

Introduction

HIV/AIDS remains a public health issue affecting 35.3 million persons globally (UNAIDS, 2013). The HIV prevalence among children aged 18 months to 14 years was 0.9% (National AIDS and STI Control Programme Kenya, 2014) and 2.7% among youth aged 15–24 years (UNICEF, 2013). In 2012, the adult HIV prevalence was 6% (UNAIDS, 2013), and 5% of Kenyan homes had a HIV-positive head of household (National AIDS and STI Control Programme Kenya, 2014). HIV-positive and negative children are known to experience varying effects (Kennedy et al, 2010; Murphy, 2008; Vallerand et al, 2005). HIV-positive mothers in a South African study, reported that their HIV-negative children accepted disclosure of their illnesses calmly; some showed emotions such as surprise and confusion (Rochat et al, 2014; Rochat, Mkwanazi & Bland, 2013)

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