Factors Associated with Caretaker’s Readiness for Disclosure of HIV Diagnosis to HIV-Infected Children in Bangkok, Thailand

To determine factors associated with caretaker’s readiness to disclose an HIV diagnosis to their child, a prospective study was conducted among caretakers of HIV-infected children aged seven to 16 years who were receiving care at two paediatric HIV treatment centres in Bangkok. 

Caretakers were offered readiness preparation counselling and their perceptions on disclosure were assessed using a semi-structured questionnaire. Among caretakers who had participated in the readiness preparation process for at least one year, 71% (195/273) were ready for disclosure. Using logistic regression analysis, we found that child’s age of nine years or older, child’s severe immunosuppression, caretakers having prior discussion with their child about the illness, caretaker’s perception that their child had the ability to understand the HIV diagnosis and to keep it secret, and caretaker’s opinion that the proper age for disclosure is between seven and 12 years old were associated with caretaker’s readiness for disclosure. 

These determinants may be useful for guiding disclosure readiness preparation counselling...

Table

Caretaker’s factors relating to disclosing HIV diagnosis to their child.

Ideas and perceptions	n/N (%)
Caretakers having talked with child about child’s illness	240/268 (90)
Caretaker’s perception that child had the ability to understand HIV diagnosis	220/249 (88)
Caretaker’s perception that child had learning problem	25/273 (9.2)
Caretaker’s perception that child was able to keep HIV diagnosis confidential	67/249 (27)
Caretaker’s perception that child might have been suspicious of his/her HIV diagnosis	56/268 (21)
Caretaker’s expectation that the child’s adherence/self-care might be improved after disclosure	91/150 (61)
Caretaker’s concern that disclosure might have negative impact on parent–child relationship	7/249 (2.6)
Caretaker’s concern disclosure would create stigma to their child	15/249 (6.0)
Caretaker’s opinion on the proper ages of children for disclosure
7–12 years	131/217 (60)
>12 years	86/217 (40)

...Consistent with other studies, the most important factor for disclosure readiness was the caretaker’s perception of their child’s cognitive maturity to comprehend the disease and the implications of their infection.^9,14–17 Caretakers of older children (i.e., nine years or older) in our sample were more likely to be ready for disclosure.⁹ It was also found that caretakers who thought that the appropriate child’s age for disclosure was between seven and 12, as opposed to more than 12 years old, were more likely to be ready to disclose HIV diagnosis to their child. This suggests that caretaker’s perception about the developmental capacity to understand the disease concept among school-age children is a critical factor associated with caretaker readiness for disclosure.

Full article at:   http://goo.gl/oMz1UG

By:   W Punpanich,¹ R Lolekha,² K Chokephaibulkit,³ T Naiwatanakul,² P Leowsrisook,¹ and V Boon-yasidhi³

¹Queen Sirikit National Institute for Child Health, Ministry of Public Health, Bangkok, Thailand

²Thailand MOPH-U.S. CDC Collaboration (TUC), Global AIDS Program (GAP), Bangkok, Thailand

³Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Corresponding author: Vitharon Boon-yasidhi, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10170, Thailand. Email: ht.ca.lodiham@oob.norahtiv

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