For whom the bell tolls: Parenting decisions and challenges faced by mothers who are HIV seropositive.

Abstract

We delineate critical parenting issues faced by mothers who are HIV seropositive. These issues, which must be considered within the environmental context in which most of these women live, include major life decisions (pregnancy, disclosure, future planning) and daily life challenges (day-to-day parenting, managing other burdens). Research is virtually nonexistent and, as most parenting issues faced by mothers who are seropositive are unique, it is not possible to draw upon work with other parents for direction and solution. Research on the parenting issues faced by these women is needed to guide intewentions and policy.

Disclosure of Maternal HIV-Infection in South Africa: Description and Relationship to Child Functioning

“…Additionally, mothers who do not disclose may run the risk of children finding out from other sources (Black 1993), and when stressors in the family are kept a secret, children may feel anxious and confused (Murphy et al 2001). Alternatively, disadvantages to disclosure may include burdening a child with a secret that s/he may be expected to keep from others, as well as generating fear related to maternal mortality (Armistead and Forehand 1995). Importantly, this conceptual work, along with the empirical literature focused on disclosure, was based on research with U.S. families and may or may not generalize to South African families.…”

“…Studies in the U.S. suggest that disclosure of serostatus is one of the three main concerns of MLWH (Armistead and Forehand 1995;Faithful 1997), and call for mothers to evaluate both the benefits and risks of disclosure (Murphy et al 2003). Early conceptual work in the U.S. identified several potential benefits of disclosure, including the ability for children to communicate openly with their mother about HIV and their concerns about her health (Armistead and Forehand 1995;Doll and Dillon 1997;Zay and Roma 1994). Additionally, mothers who do not disclose may run the risk of children finding out from other sources (Black 1993), and when stressors in the family are kept a secret, children may feel anxious and confused (Murphy et al 2001).…”

Children's body mass index and nutrition intake in HIV/AIDS

“…Parents living with HIV must cope not only with their own physical health symptoms, complex medication regimens (Gwadz et al, 1999), stigma (Herek & Capitanio, 1993) and fear of AIDS-related death, but must also care for their family (Armistead & Forehand, 1995;Rotheram-Borus, Murphy, Miller, & Draimin, 1997). Previous studies have demonstrated that many children affected by HIV/AIDS were not able to have a normal childhood (Bor, Miller, & Goldman, 1993;Pequegnat et al, 2001;Rotheram-Borus, Flannery, Rice, & Lester, 2005;Rotheram-Borus, Lee, Gwadz, & Draimin, 2001;Schuster, et al, 2000;Wekesa, 2000).…”

Disclosure of Maternal HIV Status to Children: To Tell or Not To Tell … That is the Question

“…Several authors have proposed that a multitude of factors may be associated with the decision to disclose including: decreased parental stress associated with keeping the "secret" and hiding health seeking behavior (Armistead & Forehand, 1995), decreased child stress related to living with an unnamed illness (Murphy et al, 2001;Nagler et al, 1995;Ostrom et al, 2006), increased control over the process of disclosure (Murphy et al, 2003;Ostrom et al, 2006), improved communication to facilitate sharing of accurate information regarding the disease and prevention (Armistead et al, 1999;Schrimshaw & Siegel, 2002); desire to share the news before severe illness or death ensues (Schrimshaw & Siegel, 2002); and increased opportunity to involve children in future planning and to prepare for future loss (Armistead et al, 1997;Ostrom et al, 2006;Pilowsky et al, 1999).…”