"It's a secret between us": a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo.
| dc.contributor.author | Sumbi, EM | |
| dc.contributor.author | Venables, E | |
| dc.contributor.author | Harrison, R | |
| dc.contributor.author | Garcia, M | |
| dc.contributor.author | Iakovidi, K | |
| dc.contributor.author | van Cutsem, G | |
| dc.contributor.author | Chalachala, JL | |
| dc.date.accessioned | 2021-04-03T20:00:41Z | |
| dc.date.available | 2021-04-03T20:00:41Z | |
| dc.date.issued | 2021-02-06 | |
| dc.date.submitted | 2021-04-02 | |
| dc.identifier.pmid | 33549066 | |
| dc.identifier.doi | 10.1186/s12889-021-10327-5 | |
| dc.identifier.uri | http://hdl.handle.net/10144/619897 | |
| dc.description.abstract | Background: It is estimated that 64,000 children under 15 years of age are living with HIV in the Democratic Republic of Congo (DRC). Non-disclosure - in which the child is not informed about their HIV status - is likely to be associated with poor outcomes during adolescence including increased risk of poor adherence and retention, and treatment failure. Disclosing a child's HIV status to them can be a difficult process for care-givers and children, and in this qualitative study we explored child and care-giver experiences of the process of disclosing, including reasons for delay. Methods: A total of 22 in-depth interviews with care-givers and 11 in-depth interviews with HIV positive children whom they were caring for were conducted in one health-care facility in the capital city of Kinshasa. Care-givers were purposively sampled to include those who had disclosed to their children and those who had not. Care-givers included biological parents, grandmothers, siblings and community members and 86% of them were female. Interviews were conducted in French and Lingala. All interviews were translated and/or transcribed into French before being manually coded. Thematic analysis was conducted. Verbal informed consent/assent was taken from all interviewees. Results: At the time of interview, the mean age of children and care-givers was 17 (15-19) and 47 (21-70) years old, respectively. Many care-givers had lost family members due to HIV and several were HIV positive themselves. Reasons for non-disclosure included fear of stigmatisation; wanting to protect the child and not having enough knowledge about HIV or the status of the child to disclose. Several children had multiple care-givers, which also delayed disclosure, as responsibility for the child was shared. In addition, some care-givers were struggling to accept their own HIV status and did not want their child to blame them for their own positive status by disclosing to them. Conclusions: Child disclosure is a complex process for care-givers, health-care workers and the children themselves. Care-givers may require additional psycho-social support to manage disclosure. Involving multiple care-givers in the care of HIV positive children could offer additional support for disclosure. | en_US |
| dc.language.iso | en | en_US |
| dc.publisher | BMC | en_US |
| dc.rights | With thanks to BMC. | en_US |
| dc.subject | Children | |
| dc.subject | Democratic Republic of Congo | |
| dc.subject | Disclosure | |
| dc.subject | HIV care continuum | |
| dc.subject | Qualitative research | |
| dc.title | "It's a secret between us": a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo. | en_US |
| dc.type | Article | |
| dc.identifier.eissn | 1471-2458 | |
| dc.identifier.journal | BMC Public Health | en_US |
| dc.source.journaltitle | BMC public health | |
| dc.source.volume | 21 | |
| dc.source.issue | 1 | |
| dc.source.beginpage | 313 | |
| dc.source.endpage | ||
| refterms.dateFOA | 2021-04-03T20:00:42Z | |
| dc.source.country | England |
