A social research project on HIV disclosure for HIV-affected family called “Mom tells…..Mom loved” was recently conducted by the Thai Red Cross AIDS Research Centre, with support from the Italian Red Cross.
Mom Tells Mom Loved: an integrated approach of HIV disclosure for HIV-affected family
This project is a collaboration between the Italian Red Cross and the TRC-ARC with the aim to develop an HIV disclosure model for HIV-affected families in Thailand, to improve the health status communication skill within families, to improve the quality of life and to strengthen the knowledge and capacity, counseling skill and disclosure technique of healthcare workers regarding the Integrated Approaches of HIV Disclosure for HIV-affected Family. The project has completed the staff training for disclosure techniques by disclosure experts, the survey of the readiness and factors associated with health status communication within families, group sessions and “Healthy Camp” activities. The study will complete in December 2012.
The data from the survey of the readiness and factors associated with health status communication within families have shown that among 367 HIV-infected parents (male 18.8%, women 81.2%), 0.8% already disclosed their HIV status to their children, 14.7% had not yet disclosed but were willing and ready to disclose, 50.4% were willing but not ready, 33.2% didn’t want to disclose, and 0.8% didn’t respond. Children included 59 boys and 66 girls. Mean (SD) age was 37.5 (+5.2) years for parents, 12.0 (+3) years for HIV-infected children (n=31), and 11.5 (+4.3) years for HIV-uninfected children (n=94).
Parent’s major concerns for disclosure included fears that the child is too young to understand HIV and to keep it confidential (47%), the child may be afraid of getting HIV from them (19%), and the child may think of parents as bad persons (9%). Families with uninfected children had significant higher willingness and readiness than the families with infected children (p=0.03).
Age 31-35 years (OR=3.06, 95%CI 1.01-15.66, p=<0.01), being male (OR=5.06, 95%CI 1.55-16.50, p=<0.01), and children’s age >17 years (OR=31.48, 95%CI 10.71-92.57, p=<0.001) were predictors of the willingness to disclose. Age 31-35 and >41 years (OR=5.33, 95%CI 1.33-21.36 and 5.18, 95%CI 1.27-27.11, respectively, p=0.02), higher education (OR=2.26, 95%CI 1.26-4.04, p=<0.01), having >3 children (OR=3.15, 95%CI 1.37-7.23, p=0.02), and children’s age >17 years (OR=2.75, 95%CI 1.47-5.14, p=<0.01) were associated with the readiness to disclose. From the survey, we can concluded that more than half of HIV-infected Thai parents were willing to disclose their HIV status to their children. When and how to disclose without creating negative consequences were major challenges. Parental HIV disclosure studies and demonstration models are needed to guide recommendations in this field.
Standard of Procedure (SOP) of HIV disclosure model