Caregivers’ Intentions to Disclose HIV Diagnosis to Children Living with HIV in South Africa: A Theory-Based Approach

Abstract

When people know their HIV serostatus, they can take steps to manage their health and the risk of transmitting HIV to others. Mounting evidence indicates that caregivers often do not disclose to HIV-positive children that the children are living with HIV, but little is known about the modifiable determinants of pediatric HIV disclosure. The present study examined theory-of-planned-behavior predictors of the intention to disclose to children their HIV diagnosis. The participants were 100 caregivers of HIV-positive children in Eastern Cape Province, South Africa. Proportional-odds logistic regression analysis revealed that normative support for disclosure and caregiver-child communication predicted the intention to disclose, whereas behavioral beliefs regarding the consequences of disclosing and self-efficacy to disclose did not. The results suggest that interventions to increase pediatric HIV disclosure in South Africa should help caregivers enlist support for disclosure among important referents and improve communication with their HIV-infected children.

A model of caregiver paediatric HIV disclosure decision-making

“…D. Bird & Voisin, 2011; Gaskins et al, 2012; Iwelunmor et al, 2014; Rutledge, 2009). Quantitative studies found support for some or all of the individual theory components (Gaskins et al, 2012; Jemmott et al, 2014; Semple et al, 1999; Serovich, Lim, & Mason, 2008). …”

“…Bird, 2009; J. D. Bird & Voisin, 2011; Gaskins et al, 2012; Jemmott et al, 2014; Rutledge, 2007; Semple, Patterson, Shaw, Pedlow, & Grant, 1999; Serovich, 2001). Other individual factors included self-efficacy (Gaskins et al, 2012; Jemmott et al, 2014; Semple et al, 1999), approach/avoidance goals (Chaudoir, Fisher, & Simoni, 2011), normative beliefs (J.…”

“…Other individual factors included self-efficacy (Gaskins et al, 2012; Jemmott et al, 2014; Semple et al, 1999), approach/avoidance goals (Chaudoir, Fisher, & Simoni, 2011), normative beliefs (J. D. Bird & Voisin, 2011; Jemmott et al, 2014), HIV knowledge (Gaskins et al, 2012), privacy/responsibility beliefs (J. D. Bird & Voisin, 2011; Rutledge, 2007) and disclosure intention (Jemmott et al, 2014).…”

“…D. Bird & Voisin, 2011; Jemmott et al, 2014), HIV knowledge (Gaskins et al, 2012), privacy/responsibility beliefs (J. D. Bird & Voisin, 2011; Rutledge, 2007) and disclosure intention (Jemmott et al, 2014). Contextual and relational factors including partner factors, sexual setting, sexual risk behaviour (J.…”

HIV/STI risk-reduction intervention efficacy with South African adolescents over 54 months.

“…The number of items, coefficient alpha, and mean (SE) by intervention condition and data-collection period for each theoretical construct are in Table 1. HIV risk-reduction knowledge (Jemmott, Jemmott, Braverman, & Fong, 2005) and its subscales on cultural myths (J. B. Jemmott, 3rd et al, 2013) and condom-use knowledge (Jemmott et al, 2005) are the sum of the correctly answered true-false questions.…”