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

Autores/as

  • G. Gachanja Walden University

DOI:

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

Palabras clave:

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

Resumen

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 All children were affected by disclosure, one had a delayed emotional outburst, and another was still angry and withdrawn years later.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.

 

Biografía del autor/a

G. Gachanja, Walden University

 

Dr. Grace Gachanja is a Global Safety Scientist and has worked for the last eight years in various drug safety surveillance capacities in a large biotech company. She received her PhD in Public Health from Walden University, a MPH from University of Illinois at Springfield, a BS in Health Education and Promotion from Western Illinois University, and a Registered Nurse diploma from the Nairobi Hospital School of Nursing located in Kenya. Dr. Gachanja's research interests are in HIV/AIDS, specifically that which involves HIV disclosure of a parent’s and/or a child’s illness from HIV-positive parents to their HIV-positive and negative children. She continues to advocate for HIV disclosure from parent to child by presenting her research at major conferences and writing scientific manuscripts for journal publication.

Published Manuscripts:

  1. Gachanja, G., Burkholder, G. J., & Ferraro, A. (2014). HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya.  PeerJ, e486. doi: http://dx.doi.org/10.7717/peerj.486. Full text available at https://peerj.com/articles/486/ 
  2. Gachanja, G., Burkholder, G. J., & Ferraro, A. (2014). HIV-positive parents' accounts on disclosure preparation activities in Kenya. JSBHS, 8(1), 18-37. doi: 10.5590/JSBHS.2014.08.1.02. Full text available at http://scholarworks.waldenu.edu/jsbhs/vol8/iss1/1/ 
Manuscripts Under Peer Review:

Gachanja, G. A rapid assessment of HIV post-disclosure experiences of urban school-aged children in Kenya. Preprint available at https://peerj.com/preprints/821/ 

Presentations:

  1. Gachanja, G., Burkholder, G. J., & Ferraro, A. (2012, Oct). Child, parent, and healthcare professionals' perspectives o HIV infection status disclosure to children.  Poster session presented at the annual meeting of the American Public Health Association, San Francisco, CA.
  2. Gachanja, G., Burkholder, G. J., & Ferraro, A. (2013, Nov). HIV-positive parents disclosure-related preparation activities in Kenya. Poster session presented at the annual meeting of the American Public Health Association, Boston, MA.
  3. Gachanja, G., Burkholder, G. J., & Ferraro, A. (2014, Nov). Parents' and children's emotions spanning the HIV disclosure process in Kenya. Abstract accepted for roundtable presentation at the annual meeting of the American Public Health Association, New Orleans, LA.

Dissertation

Gachanja, G. (2012). Child, parent, and healthcare professionals' perspectives on HIV infection status disclosure to children. (Doctoral dissertation). Retrieved from Proquest. (922421235).

 

Citas

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

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Publicado

2015-07-22

Número

Vol. 8 Núm. 1 (2015): Integration, Participation and Identity: Understanding Diversity

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