A couple’s marital disharmony and its psychological effects on their children during the HIV disclosure process in Kenya

Abstract

HIV-positive parents are challenged with disclosure to their children. Limited published data exists on how HIV-positive parents perform disclosure to all their children in the household. To start addressing this gap, data is presented on a couple's HIV disclosure experiences to all their children. The couple participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Each underwent an individualized in-depth semi-structured interview. Their interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and post-disclosure psychological effects on the family. The couple's narration of their diagnoses, and disclosure experiences to their children differed significantly. Ongoing poor paternal health caused persistent inquisitive questions from children. A poor paternal-children relationship, accompanied with his avoidance and non-involvement in disclosure matters caused the mother to fully disclose both parents' illnesses to the four oldest children. These children were affected by disclosure and held animosity towards their father. One had an emotional outburst directed at the father, while another still displayed anger and withdrawal years later. Therefore, the couple was hesitant to fully disclose their illnesses to their youngest son and differed in how they wanted to disclose to him. HIV-positive parents with poor relationships among family members before HIV testing and/or disclosure should be provided with intense counseling aimed at increasing family cohesion. Extra support before, during, and after disclosure may be required for these families to increase positive outcomes.

Mothering at a distance and disclosure of maternal HIV to children in Kingston, Jamaica

“…The earlier disclosure literature (e.g., Armistead et al, 2001;Tompkins, 2007;Moore, Kalanzi and Amey, 2008) presented disclosure as a binary (disclosure/non-disclosure), but more recent research (e.g., Madiba and Matlala, 2012;Kyaddondo et al, 2013;Tiendrebeogo et al, 2013;Muparamoto and Chiweshe, 2015) suggests disclosure is a more complex phenomenon. For example, some authors distinguish between: 'full ' and 'partial' disclosure (e.g., De Baets et al, 2008;Gachanja, 2014; Ferraro, 2014a, 2014b;Gachanja and Burkholder, 2016); 'brief' Mothering at a distance and disclosure of maternal HIV in Kingston, Jamaica Clifford, Craig & McCourt…”