Telling Children They Have HIV: Lessons Learned from Findings of a Qualitative Study in Sub-Saharan Africa
Telling Children They Have HIV: Lessons Learned from Findings of a Qualitative Study in Sub-Saharan Africa
复制标题
DOI：
10.1089/apc.2009.0217
复制
发表时间：
2010-04-01
影响因子：
4.9
通讯作者：
Behets, Frieda
中科院分区：
文献类型：
--
作者：
Vaz, Lara M. E.;Eng, Eugenia;Behets, Frieda
发展中国家感染艾滋病毒的儿童由于获得抗逆转录病毒治疗方案而寿命更长。随着年龄的增长，他们的父母/监护人面临着是否、何时以及如何将其艾滋病毒状况告知子女的困难决定。据报道，向儿童披露信息会对社会、心理和行为产生积极和消极影响，包括改善对药物治疗方案的依从性。因此，从艾滋病毒阳性儿童的角度理解披露过程对制定这些干预措施至关重要。通过儿童的经历，我们可以了解哪些做法行之有效，哪些需要加强，以及当前披露做法中缺少哪些内容。我们在刚果民主共和国的金沙萨对八对母子进行了深入访谈。这些儿童参加了一个全面的艾滋病毒儿科护理和治疗项目，并已被告知他们的艾滋病毒诊断。在分析中，我们特别强调了儿童与其照顾者和医疗保健提供者就其疾病进行沟通的报告。在披露之前、期间和之后，出现了儿童与其照顾者以及提供者之间沟通有限的模式。从儿童的角度来看，在这项研究中，披露在很大程度上是一个离散的事件，而不是一个过程。围绕艾滋病毒/艾滋病的社会文化背景，以及健康状况、父母与子女沟通的变化以及卫生服务提供者与其所照顾儿童之间的关系，应成为与治疗方案一起提供的心理社会干预措施的依据。
HIV-infected children in developing countries are living longer lives as they gain access to antiretroviral treatment programs. As they grow older, their parents/guardians are faced with the difficult decision of if, when, and how to inform their child of his/her HIV status. Both negative and positive social, psychological, and behavioral impacts of disclosure to children have been reported, including improved adherence to medication regimens. Understanding the disclosure process from the perspective of HIV positive children, therefore, is critical to developing these interventions. Through children's experiences we can learn about what works well, what needs to be strengthened, and what is missing in current disclosure practices. We conducted in-depth interviews with eight caregiver-child dyads in Kinshasa, Democratic Republic of the Congo. The children were in a comprehensive HIV pediatric care and treatment program and had already been told their HIV diagnosis. For the analysis we placed particular emphasis on children's reports of communication with their caregivers and health care providers about their illness. Patterns emerged of limited communication between children and their caregivers as well as their providers, before, during, and after disclosure. From the perspective of children in this study, disclosure was largely a discrete event rather than a process. Sociocultural contexts surrounding HIV/AIDS, as well as health status, variations in parent-child communication and the relationships between health providers and children under their care, should inform psychosocial interventions delivered alongside treatment programs.