Parental disclosure of pediatric HIV status: A qualitative assessment of disclosure and pediatric an

1
Parental disclosure of pediatric HIV status A
qualitative assessment of disclosure and
pediatric antiretroviral therapy adherence in
western Kenya
Rachel C. Vreeman, MD, MS Winstone M. Nyandiko,
MBChB, MMED Samwel O. Ayaya, MBChB, MMED Eunice
G. Walumbe, MPH David G. Marrero, PhD Thomas S.
Inui, ScM, MD
2
Objective

• To identify key factors contributing to pediatric
  ART adherence in western Kenya

Methods

• Qualitative study involving 10 focus groups and
  35 key informant interviews (N131) with parents
  and caregivers of HIV-infected children receiving
  ART through large HIV care system in western Kenya

3
Caregiver disclosure of childs HIV status to the
child
Parental disclosure and pediatric ART adherence
Rachel Vreeman, MD, MS

• Disclosure to child related to pediatric ART
  adherence
• Most did not disclose childs HIV status to child
• Concerns about disclosure to child
• Adverse psychological consequences
• Developmental readiness
• Avoiding childs subsequent disclosure to others

4
Caregiver disclosure of childs HIV status to
others
Parental disclosure and pediatric ART adherence
Rachel Vreeman, MD, MS

• Disclosure to others also related to pediatric
  ART adherence
• Themes related to disclosure to others
• Perceived need to hide condition
• Non-acceptance
• Fear of isolation
• Perceived stigma
• Experienced stigma
• Negative community beliefs about HIV treatment