HIV status disclosure to perinatally-infected adolescents in Zimbabwe: a qualitative study of adolescent and healthcare worker perspectives.
HIV status disclosure to perinatally-infected adolescents in Zimbabwe: a qualitative study of adolescent and healthcare worker perspectives.
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DOI：
10.1371/journal.pone.0087322
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Ferrand RA
中科院分区：
文献类型：
--
作者：
Kidia KK;Mupambireyi Z;Cluver L;Ndhlovu CE;Borok M;Ferrand RA
由于抗逆转录病毒治疗的扩大，越来越多感染艾滋病毒的儿童进入青春期。随着这些儿童的成长和超越死亡的直接威胁，就出现了向他们通报其艾滋病毒状况的问题。这项研究旨在了解围产期感染的青少年如何了解他们的艾滋病毒状况，并检查他们对披露过程的偏好。在津巴布韦哈拉雷的一家艾滋病毒诊所，对31名（14名男性，17名女性）16-20岁的围产期感染青少年进行了深入访谈，重点关注青少年披露信息的经历。此外，15名卫生保健工作者（1名男性，14名女性）参加了两个焦点小组，重点是卫生保健工作者在诊所中关于信息披露的做法。采用有目的抽样方法招募参与者。开发了编码框架，并使用扎根理论方法提取了主要主题。医护人员鼓励护理人员在家庭环境中主动披露。然而，许多青少年更愿意在诊所医护人员在场的情况下透露自己的情况，因为这样可以让他们获得准确的信息，也可以让测试结果看起来更可信。青少年从诊所同伴之间分享的经历中了解到更多关于艾滋病毒阳性状态的具体信息以及这种状态的意义。向青少年披露艾滋病毒状况不同于向更年幼的儿童披露，需要有针对性的、适合年龄的指导方针。在医疗保健机构中向这一年龄组披露可能有助于克服与护理人员在家庭环境中披露有关的一些障碍，并使艾滋病毒状况对青少年来说似乎更可信。该研究还强调了青少年同伴支持的价值，这有助于减轻照顾者和卫生保健工作者的心理社会护理负担。
Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. As these children grow and surpass the immediate threat of death, the issue of informing them of their HIV status arises. This study aimed to understand how perinatally-infected adolescents learn about their HIV-status as well as to examine their preferences for the disclosure process. In-depth interviews were conducted with 31 (14 male, 17 female) perinatally-infected adolescents aged 16–20 at an HIV clinic in Harare, Zimbabwe, and focused on adolescents' experiences of disclosure. In addition, 15 (1 male, 14 female) healthcare workers participated in two focus groups that were centred on healthcare workers' practices surrounding disclosure in the clinic. Purposive sampling was used to recruit participants. A coding frame was developed and major themes were extracted using grounded theory methods. Healthcare workers encouraged caregivers to initiate disclosure in the home environment. However, many adolescents preferred disclosure to take place in the presence of healthcare workers at the clinic because it gave them access to accurate information as well as an environment that made test results seem more credible. Adolescents learned more specific information about living with an HIV-positive status and the meaning of that status from shared experiences among peers at the clinic. HIV-status disclosure to adolescents is distinct from disclosure to younger children and requires tailored, age-appropriate guidelines. Disclosure to this age group in a healthcare setting may help overcome some of the barriers associated with caregivers disclosing in the home environment and make the HIV status seem more credible to an adolescent. The study also highlights the value of peer support among adolescents, which could help reduce the burden of psychosocial care on caregivers and healthcare workers.
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DOI：
10.1016/s0891-5245(00)33836-6
发表时间：
2000-09-01
期刊：
Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
影响因子：
--
作者：
Instone, S L
通讯作者：
Instone, S L
影响因子：
2
作者：
Domek, Gretchen J.
通讯作者：
Domek, Gretchen J.
DOI：
10.1097/01.qai.0000151079.33935.79
发表时间：
2005-08-01
影响因子：
3.6
作者：
Marks, G;Crepaz, N;Janssen, RS
通讯作者：
Janssen, RS
影响因子：
4.4
作者：
Bikaako-Kajura, Winnie;Luyirika, Emmanuel;Bunnell, Rebecca
通讯作者：
Bunnell, Rebecca
影响因子：
4.9
作者：
MAYER, RE
通讯作者：
MAYER, RE