Communication about HIV and death: Maternal reports of primary school-aged children's questions after maternal HIV disclosure in rural South Africa

Autor: Ruth M. Bland, Joanie Mitchell, Alan Stein, Mark Tomlinson, Anina M. Lubbe, Tamsen J. Rochat
Rok vydání: 2017
Předmět:
Adult
Male
Rural Population
medicine.medical_specialty
Health (social science)
Multivariate analysis
Adolescent
media_common.quotation_subject
Child Behavior
Mothers
HIV Infections
CBCL
Truth Disclosure
Logistic regression
Article
Parental Death
Health(social science)
South Africa
03 medical and health sciences
0302 clinical medicine
History and Philosophy of Science
Acquired immunodeficiency syndrome (AIDS)
Humans
Medicine
0501 psychology and cognitive sciences
030212 general & internal medicine
Child
Psychiatry
Children
Qualitative Research
media_common
HIV disclosure
business.industry
Communication
05 social sciences
Middle Aged
medicine.disease
Mental health
Questions
Mother-Child Relations
Checklist
3. Good health
Death
Maternal Death
Female
Psychological resilience
business
050104 developmental & child psychology
Demography
Zdroj: Social Science & Medicine (1982)
ISSN: 0277-9536
Popis: Introduction Children's understanding of HIV and death in epidemic regions is under-researched. We investigated children's death-related questions post maternal HIV-disclosure. Secondary aims examined characteristics associated with death-related questions and consequences for children's mental health. Methods HIV-infected mothers (N = 281) were supported to disclose their HIV status to their children (6–10 years) in an uncontrolled pre-post intervention evaluation. Children's questions post-disclosure were collected by maternal report, 1–2 weeks post-disclosure. 61/281 children asked 88 death-related questions, which were analysed qualitatively. Logistic regression analyses examined characteristics associated with death-related questions. Using the parent-report Child Behaviour Checklist (CBCL), linear regression analysis examined differences in total CBCL problems by group, controlling for baseline. Results Children's questions were grouped into three themes: ‘threats’; ‘implications’ and ‘clarifications’. Children were most concerned about the threat of death, mother's survival, and prior family deaths. In multivariate analysis variables significantly associated with asking death-related questions included an absence of regular remittance to the mother (AOR 0.25 [CI 0.10, 0.59] p = 0.002), mother reporting the child's initial reaction to disclosure being “frightened” (AOR 6.57 [CI 2.75, 15.70] p=
Highlights • Children living in HIV epidemic communities are exposed to death at young ages. • Primary-school aged children understand information on HIV, illness and death. • Intervention training successfully prepared mothers to communicate about death. • Communication about death did not increase children’s mental health problems. • HIV disclosure creates opportunities to communicate with and reassure children.
Databáze: OpenAIRE
Externí odkaz: