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dc.contributor.authorSumbi, EM
dc.contributor.authorVenables, E
dc.contributor.authorHarrison, R
dc.contributor.authorGarcia, M
dc.contributor.authorIakovidi, K
dc.contributor.authorvan Cutsem, G
dc.contributor.authorChalachala, JL
dc.date.accessioned2021-04-03T20:00:41Z
dc.date.available2021-04-03T20:00:41Z
dc.date.issued2021-02-06
dc.date.submitted2021-04-02
dc.identifier.pmid33549066
dc.identifier.doi10.1186/s12889-021-10327-5
dc.identifier.urihttp://hdl.handle.net/10144/619897
dc.description.abstractBackground: 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.isoenen_US
dc.publisherBMCen_US
dc.rightsWith thanks to BMC.en_US
dc.subjectChildren
dc.subjectDemocratic Republic of Congo
dc.subjectDisclosure
dc.subjectHIV care continuum
dc.subjectQualitative 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.typeArticle
dc.identifier.eissn1471-2458
dc.identifier.journalBMC Public Healthen_US
dc.source.journaltitleBMC public health
dc.source.volume21
dc.source.issue1
dc.source.beginpage313
dc.source.endpage
refterms.dateFOA2021-04-03T20:00:42Z
dc.source.countryEngland


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