Why Tell Children: A Synthesis of the Global Literature on Reasons for Disclosing or Not Disclosing an HIV Diagnosis to Children 12 and under.
Why Tell Children: A Synthesis of the Global Literature on Reasons for Disclosing or Not Disclosing an HIV Diagnosis to Children 12 and under.
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DOI：
10.3389/fpubh.2016.00181
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发表时间：
2016
影响因子：
5.2
通讯作者：
Okoro CN
中科院分区：
文献类型：
--
作者：
Krauss BJ;Letteney S;Okoro CN
虽然对成年人和青少年来说，了解自己的艾滋病毒诊断对心理和健康的好处已经有了记录，但对年幼的儿童来说，这一做法仍在发展中。是否告诉儿童他/她感染艾滋病毒的缓和条件因地区和当地情况而异。这些问题包括治疗的可及性、将艾滋病毒视为一种耻辱的疾病、艾滋病毒的流行以及伴随而来的任何疾病与艾滋病毒有关的推定、父母或照料者对儿童反应的担忧、儿童健康恶化的假设、关于童年和儿童是否愿意了解诊断的假设，以及缺乏防止受影响儿童在学校遭受欺凌的政策。在这篇对全球文献的系统回顾中，我们总结了照顾者告诉或不告诉12岁和被诊断为艾滋病毒的儿童的原因。我们还包括儿童反思他们被告知的愿望的文章。虽然给出了告诉儿童的广泛理由--例如，帮助预防、适应疾病(例如，主要是促进坚持治疗)、了解社会反应和维持儿童与成人的关系--但不告诉儿童的理由范围较小，通常与直接儿童或照顾者的幸福或不适有关。建议通过在披露之前、期间和之后提供支持来改善披露的背景，并通过扩大样本和改进方法来推进研究议程。
While the psychological and health benefits of knowing one’s HIV diagnosis have been documented for adults and adolescents, practice is still in development for younger children. Moderating conditions for whether or not to tell a child he/she has HIV vary by region and local context. They include accessibility of treatment, consideration of HIV as a stigmatizing condition, prevalence of HIV, and an accompanying presumption that any illness is HIV-related, parent or caregiver concerns about child reactions, child’s worsening health, assumptions about childhood and child readiness to know a diagnosis, and lack of policies such as those that would prevent bullying of affected children in schools. In this systematic review of the global literature, we summarize the reasons caregivers give for telling or not telling children 12 and under their HIV diagnosis. We also include articles in which children reflect on their desires for being told. While a broad number of reasons are given for telling a child – e.g., to aid in prevention, adaptation to illness (e.g., primarily to promote treatment adherence), understanding social reactions, and maintaining the child–adult relationship – a narrower range of reasons, often related to immediate child or caregiver well-being or discomfort, are given for not telling. Recommendations are made to improve the context for disclosure by providing supports before, during, and after disclosure and to advance the research agenda by broadening samples and refining approaches.
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