Abstract

Disclosure of HIV status to children is a challenge parents living with HIV face. To evaluate predictors of maternal HIV disclosure in a low-income clinic in the U.S. that serves an African American, Hispanic and immigrant population with high HIV prevalence, 172 caregivers with 608 children completed a standardized survey. Caregivers were 93% female, 84% biological mothers, and 34% foreign born. Sixty-two (36%) caregivers had at least one disclosed child, 42 of whom also had other nondisclosed children. Of all children, 581 (96%) were uninfected and 181 (30%) were disclosed. Caregiver's U.S. birth (OR: 2.32, 95% CI 1.20-4.52), child's age (OR: 1.2/year, 95% CI 1.16-1.24), and increased HIV-stigma perception by caregiver (1.06/point increase, 95% CI 1.04-1.09) predicted disclosure. Children were more often disclosed if their caregiver was born in the U.S. or reported higher HIV-related stigma. These findings suggest that complex family context may complicate disclosure, particularly among immigrants.

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