Social support, stigma, and HIV disclosure among parents living with HIV in Guangxi, China

Abstract

Both stigma and social support have been identified to be associated with HIV status disclosure among people living with HIV. This study aimed to examine cross-sectional associations of perceived social support and multiple types of stigma with both disclosure to various target groups and timing of disclosure among parents living with HIV (PLHIV) in Guangxi, China. Cross-sectional data from 1254 PLHIV in Guangxi, China were analyzed. Measures included demographics, disclosure to specific groups (steady partner/spouse, children, family and others) and timing of disclosure, perceived social support, and three types of HIV-related stigma (perceived, internalized, and enacted stigma). Logistic regression analyses were performed to identify the associations of interest. The participants who reported higher levels of perceived social support were more likely to have disclosed to steady partner/spouse, family or others. Those who experienced enacted stigma were more likely to have disclosed to children or family. Those who were married/cohabitating were more likely to have disclosed to steady partner/spouse, and less likely to have disclosed to children, family or others. Older PLHIV were less likely to have disclosed to steady partner/spouse, or family. Those who had a job were more likely to have disclosed to steady partner/spouse. Perceived social support appeared not to be associated with timing of disclosure. Those who disclosed within a shorter time after diagnosis were more likely to be women or have disclosed to steady partner/spouse, and less likely to have higher perceived stigma or have disclosed to family. Interventions are needed to help reduce the negative effect of perceived stigma at both family and community levels and to help enhance perceived social support in general and emotional support in particular among PLHIV, especially males and older adults.

Important Roles of Health Professionals in Maternal HIV Disclosure Among HIV-Infected Women in China

“…Older age and longer time since HIV diagnosis were associated with higher likelihood of maternal HIV disclosure. Such finding was consistent with previous studies showing that delayed parental HIV disclosure was prevalent in China [49]. HIV-infected mothers of other ethnic minorities required more support as they reported much lower prevalence of maternal HIV disclosure.…”

“…Maternal HIV disclosure may contribute to children's moral and social development at this stage [45,46]. Many published studies investigating maternal/parental HIV disclosure used the same cut-off age for children [3,4,17,25,[47][48][49][50], including those conducted in China [25,49,50]. Ethics approval was obtained from the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong (SBRE-18-431).…”

Disclosure experience among COVID‐19‐confirmed patients in China: A qualitative study

“…From a public health perspective, disclosure has been advocated due to its vital role in reducing transmission of disease (O'Connell et al, 2015). Additionally, people who disclose their disease status are more likely to gain social support, reduce self‐stigma and adopt positive coping strategies to address the disease (Ekama et al, 2012; Mao et al, 2018; Yonah et al, 2014). Despite these potential positive outcomes, disclosure can also carry several risks, such as stigma and discrimination, violence, social marginalisation or loss of employment (Kennedy et al, 2015; Nachega et al, 2012; Siu et al, 2012; Syed et al, 2015).…”

Concerns of Parental HIV Disclosure in China

“…In Chinese culture, family is the core social unit in an individual's healthcare journey, including one's experience with HIV (Qiao et al, 2015c). Family ties are among the most important relationships in supporting HIV care (Mao et al, 2018). Therefore, parents are concerned about how to approach the issue of disclosure and may be unsure if they can answer the questions their children may raise (Conserve et al, 2017), especially regarding the parents' transmission route which may disrupt family harmony.…”