I want to provide a sneak peak of the two presentations (oral presentation and poster presentation) that I am presenting at the American Public Health Association meeting.
Background: In Kenya (and elsewhere) parents and healthcare professionals are not always in agreement on if, when, and how to disclose to children. The purpose of this study was to understand healthcare professionals’ perspectives on HIV disclosure of a parent’s and a child’s HIV illness in Kenya.
Methods: The study was conducted in Nairobi, Kenya at the Kenyatta National Hospital Comprehensive Care Center. Healthcare professionals (medical doctor, clinical officer, clinical psychologist, registered nurse, social worker, and peer educator) underwent individualized semi-structured in-depth interviews. Recorded interviews were transcribed; data analysis was done in NVivo 8 using the modified Van Kam method. Interview guide questions explored various aspects of the HIV disclosure process including:
- Healthcare professionals’ role in the HIV disclosure process
- How disclosure should be approached
- When should children receive disclosure
- Who should disclose to children
- What is the appropriate timing and setting for disclosure
- Benefits, consequences, emotional, and psychological aspects of disclosure
- Services/programs available or needed by HIV-affected families going through the disclosure process
Results: The analysis of the data revealed the following five themes:
- Barriers of disclosure: healthcare professionals provided many barriers to disclosure. These were dependent on parental, child, and family factors.
- Timing of disclosure: healthcare professionals thought that the timing of disclosure depended on many factors such as health status and the readiness of the parent and child for disclosure.
- Benefits of disclosure: healthcare professionals provided many benefits that come about due to disclosure.
- Effects/Consequences of disclosure: HIV disclosure is not without consequences. Healthcare professionals provided various consequences that they had seen occur as a result of disclosure.
- Disclosure-related services: healthcare professionals stated the following were the services provided or needed for disclosure to occur.
Policy Implications: The following policy implications arise from this oral presentation and the healthcare professional’s advice:
Conclusion: In conclusion, HIV disclosure is without a doubt a difficult and complex process. This quote from the peer educator demonstrates how and why this is so:
HIV disclosure is at the center of an HIV positive person’s well being and once done helps them get social support, attend clinic visits without hiding, take and adhere to their antiretrovirals well, and just frees them to live “normally.” Healthcare professionals working with HIV positive families should get additional training on HIV disclosure so that they are able to better help them through the HIV disclosure process.
Please access the abstract and full presentation at the APHA website here.
This presentation and post was prepared with the help of Opeyemi Fasina. Please follow me on my social media channels below: