A Couple’s Marital Disharmony and its Psychological Effects on their Children during the HIV Disclosure Process in Kenya

G. Gachanja

Abstract


Limited published data exists on how HIV-positive parents perform disclosure to all their children. A couple’s HIV disclosure experience to all their children is presented. They participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process. Each underwent individualized in-depth semi-structured interviews. Interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and post-disclosure psychological effects on the family. Marital disharmony and non-involvement of the father caused the mother to fully disclose their illnesses to their four oldest children. All children were affected by disclosure, one had a delayed emotional outburst, and another was still angry and withdrawn years later. HIV-positive parents with poor relationships within the families need intense counseling and support pre, during, and post-disclosure to improve outcomes.

 


Keywords


HIV/AIDS; HIV disclosure; psychological effects of HIV disclosure; parent HIV status disclosure; resource-poor nation; Kenya

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References


American Academy of Pediatrics. (1999). Disclosure of illness status to children and adolescents with HIV infection. Pediatrics, 103(1), 164-166. doi:10.1542/peds.103.1.164

Bikaako-Kajura, W., Luyirka, E., Purcell, D. W., Downing, J., Kaharuza, F., Mermin, J., … Bunnell, R. (2006). Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda. AIDS and Behavior, 10(Suppl 1), S85-S93. doi:10.1007/s10461-006-9141-3

Blasini, I., Chantry, C., Cruz, C., Ortiz, L., Salabarria, I., Scalley, N., … Diaz, C. (2004). Disclosure model for pediatric patients living with HIV in Puerto Rico: Design, implementation, and evaluation. Developmental and Behavioral Pediatrics, 25(3), 181-189. doi:0196-206X/00/2503-0181

Brown, B. J., Oladokun, R. E., Osinusi, K., Ochigbo, S., Adewole, F., & Kanki, P. (2011). Disclosure of HIV status to infected children in a Nigerian HIV Care Programme. AIDS Care, 23(9), 1053-1058. doi: 10.1080/09540121.2011.554523

Chaudoir, S. R., Fisher, J. D., & Simoni, J. M. (2011). The disclosure process model: A review and application of the disclosure processes model. Social Science and Medicine, 72(10), 1618-1629. doi:10.1016/j.socscimed.2011.03.028

Chaudoir, S. R., & Fisher, J. D. (2010). The disclosure processes model: Understanding disclosure decision-making and post-disclosure outcomes among people living with a concealable stigmatized identity. Psychological Bulletin, 136(2), 236-256. doi:10.1037/a0018193

Creswell, J. W. (1998). Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks, CA: Sage.

Jones, D. J., Foster, S. E., Zalot, A. A., Chester, C., & King, A. (2007). Knowledge of maternal HIV/AIDS and child adjustment: The moderating role of children’s relationships with their mothers. AIDS and Behavior, 11(3), 409-420. doi:10.1007/s10461-006-9188-1

Kallem, S., Renner, L., Ghebremichael, M., & Paintsil, E. (2011). Prevalence and pattern of disclosure of HIV status in HIV-infected children in Ghana. AIDS and Behavior, 15(6), 1121-1127. doi: 10.1007/s10461-010-9741-9

Kennedy, D. P., Cowgill, B. O., Bogart, L. M., Corona, R., Ryan, G. W., Murphy, D. A., … Schuster, M. A. (2010). Parents' disclosure of their HIV infection to their children in the context of the family. AIDS and Behavior, 14(5), 1095-1105. doi: 10.1007/s10461-010-9715-y

Kouyoumdjian, F. G., Meyers, T., & Mtshizana, S. (2005). Barriers to disclosure to children with HIV. Journal of Tropical Pediatrics, 51(5), 285-287. doi:10.1093/tropej/fmi014

Lee, M. B. & Rotheram-Borus, M. J. (2002). Parents’ disclosure of HIV to their children. AIDS, 16(16), 2201-2207. Retrieved from http://journals.lww.com/aidsonline/pages/default.aspx

Moustakas, C. (1994). Phenomenological research methods. London, England: Sage Publications.

Murphy, D. A. (2008). HIV-positive mothers’ disclosure of their serostatus to their young children: A review. Clinical Child Psychology Psychiatry, 13(1), 105-122. doi:10.1177/1359104507087464

Murphy, D. A., Steers, W. N., & Stritto, M. E. D. (2001). Maternal disclosure of mothers’ HIV serostatus to their young children. Journal of Family Psychology, 15(3), 441-450. doi:10.1037//0893-3200.15.3.441

NACC and NASCOP (2012). The Kenya AIDS Epidemic Update 2011. Retrieved from http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_KE_Narrative_Report.pdf

National AIDS and STI Control Programme (2013). Kenya AIDS Indicator Survey 2012: Preliminary Report. Retrieved from http://reliefweb.int/sites/reliefweb.int/files/resources/167580994-Preliminary-Report-for-Kenya-AIDS-indicator-survey-2012-pdf_0.pdf

Nostlinger, C., Bartolib, G., Gordilloc, M., Roberfroid, D., & Colebunders, R. (2006). Children and adolescents living with HIV positive parents: Emotional and behavioural problems. Vulnerable Children and Youth Studies, 1(1), 1-15. doi: 10.1080/17450120600659036

Oberdorfer, P., Puthanakit, T., Louthrenoo, O., Charnsil, C., Sirisanthana, V., & Sisisanthana, T. (2006). Disclosure of HIV/AIDS diagnosis to HIV-infected children in Thailand. Journal of Paediatrics and Child Health, 42(5), 283-288. doi:10.1111/j.1440-1754.2006.00855.x

Omarzu, J. (2000). A disclosure decision model: Determining how and when individuals will self-disclose. Personality and Social Psychology Review, 42(2), 174-185. doi: 10.1207/S15327957PSPR0402_05

Petersen, I., Bhana, A., Myeza, N., Alicea, S., John, S., Holst, H., … Mellins, C. (2010). Psychosocial challenges and protective influences for socio-emotional coping of HIV+ adolescents in South Africa: A qualitative investigation. AIDS Care, 22(8), 970-978. doi: 10.1080/09540121003623693

Republic of Kenya. (2009). Kenya AIDS Indicator Survey 2007. Retrieved from http://www.wofak.or.ke/Publications/kais__preliminary_report_july_29.pdf _KAIS_Report_2009.pdf

Rochat, J. R., Mkwanazi, N., & Bland, R. (2013). Maternal HIV disclosure to HIV-uninfected children in rural South Africa: A pilot study of a family-based intervention. BMC Public Health, 13(147), 1-16. doi:10.1186/1471-2458-13-147

Serovich, J. M. (2001). A test of two HIV disclosure theories. AIDS Education and Prevention, 13(4), 355-364. doi:10.1521/aeap.13.4.355.21424

Shafer, A., Jones, D. J., Kotchick, B. A., Forehand, R., & The Family Health Project Research Group. (2001). Telling the children: Disclosure of maternal HIV infection and its effects on child psychosocial adjustment. Journal of Child and Family Studies, 10(3), 301-313. doi:10.1023/A:1012502527457

Tasker, M. (1992). How can I tell you? Secrecy and disclosure with children when a family member has AIDS. Betheseda, MD: Association for the Care of Children's Health.

UNAIDS. (2013). Core Epidemiology Slides. Retrieved from http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/201309_epi_core_en.pdf

Vallerand, A. H., Hough, E., Pittiglio, L., & Marvicsin, D. (2005). The process of disclosing HIV serostatus between HIV-positive mothers and their HIV-negative children. AIDS Patient Care and STDs, 19(2), 100-109. doi:10.1089/apc.2005.19.100.

Vaz, L. M. E., Maman, S., Eng, E., Barbarin, O. A., Tshikandu, T., & Behets, F. (2011). Patterns of disclosure of HIV status to infected children in a Sub-Saharan African setting. Journal of Developmental & Behavioral Pediatrics, 32(4), 307-315. doi: 10.1097/DBP.0b013e31820f7a47




DOI: https://doi.org/10.5195/hcs.2015.166

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