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Published on: February 11, 2017
Children's Positive and Negative Emotional Responses to an HIV Disclosure Study in South Africa
Candice W Ramsammy1, Lisa Galvin1,2, Celeste Joyce1
1Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Children show mixed emotions during HIV status disclosure, with many initially responding negatively. However, reassurance helps most children improve emotionally over time, enhancing caregiver-child communication.
Area of Science:
- Pediatric Psychology
- Public Health
- HIV/AIDS Research
Background:
- Disclosure of Human Immunodeficiency Virus (HIV) status to children is recognized for its benefits.
- Limited longitudinal research exists on children's emotional and behavioral responses to HIV status disclosure.
- Understanding these responses is crucial for effective psychosocial support.
Purpose of the Study:
- To describe children's longitudinal responses to HIV status disclosure.
- To document observed behaviors and emotions during disclosure counseling sessions.
- To inform healthcare provider (HCP) preparation and caregiver training for post-disclosure support.
Main Methods:
- Longitudinal study involving 30 children (aged 7-13 years) in Soweto, South Africa.
- Healthcare providers (HCPs) documented observations during an average of six disclosure counseling sessions over 78 weeks.
- Content analysis was used to analyze recorded child behaviors and expressed emotions.
Main Results:
- Most children (27/30) exhibited mixed responses to full HIV disclosure.
- A majority experienced initial negative emotions (16/27), but 10 improved with reassurance.
- Improvements in caregiver-child communication (17/30) and understanding of disclosure content were noted, though avoidance of the HIV topic persisted (16/30).
Conclusions:
- Children's responses to HIV disclosure are complex and varied, often involving initial negative emotions.
- Reassurance and ongoing support can facilitate emotional improvement and better acceptance of HIV status.
- Enhanced HCP training and caregiver support are vital for managing disclosure-related distress and promoting positive outcomes.
Abstract:
The benefits of HIV status disclosure to children is widely cited. However, few studies have reported how children respond to the process in a longitudinal fashion. This paper describes children's responses, as documented by healthcare providers (HCPs), during a longitudinal disclosure study conducted at Chris Hani Baragwanath Academic Hospital in Soweto, South Africa. Two HCPs facilitating disclosure recorded observations of 30 participating children (60% female), aged 7-13 years. Participants attended an average of six disclosure counseling sessions over 78 weeks. Observations documented by HCPs included the child's behavior and expressed emotions during the disclosure counseling sessions. The data was analyzed using content analysis. Mixed responses were observed in children who received full disclosure (27/30), with more children responding with strong negative emotions (16/27). However, 10 of those responded well to reassurance, and emotionally improved over subsequent sessions. Improvements were also observed in the communication and relationship between caregivers and children (17/30). Although most children understood the disclosure content (17/30), many were avoidant of the topic of HIV (16/30). With the understanding of the complex range of emotions elicited by HIV disclosure, we can better prepare HCPs on what to anticipate and train caregivers to further manage negative responses post-disclosure. This in turn may lead to more positive experiences of disclosure and the child's healthy acceptance of their HIV status.
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