“It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo
| dc.contributor.author | Sumbi, Elysée M | |
| dc.contributor.author | Venables, Emilie | |
| dc.contributor.author | Harrison, Rebecca | |
| dc.contributor.author | Garcia, Mariana | |
| dc.contributor.author | Iakovidi, Kleio | |
| dc.contributor.author | van Cutsem, Gilles | |
| dc.contributor.author | Chalachala, Jean L | |
| dc.date.accessioned | 2021-10-12T09:20:46Z | |
| dc.date.available | 2021-10-12T09:20:46Z | |
| dc.date.issued | 2021-02-06 | |
| dc.date.updated | 2021-02-07T04:12:44Z | |
| dc.description.abstract | Background It is estimated that 64,000 children under 15 years of age are living with HIV in the Democratic Republic of Congo (DRC). Non-disclosure – in which the child is not informed about their HIV status - is likely to be associated with poor outcomes during adolescence including increased risk of poor adherence and retention, and treatment failure. Disclosing a child’s HIV status to them can be a difficult process for care-givers and children, and in this qualitative study we explored child and care-giver experiences of the process of disclosing, including reasons for delay. Methods A total of 22 in-depth interviews with care-givers and 11 in-depth interviews with HIV positive children whom they were caring for were conducted in one health-care facility in the capital city of Kinshasa. Care-givers were purposively sampled to include those who had disclosed to their children and those who had not. Care-givers included biological parents, grandmothers, siblings and community members and 86% of them were female. Interviews were conducted in French and Lingala. All interviews were translated and/or transcribed into French before being manually coded. Thematic analysis was conducted. Verbal informed consent/assent was taken from all interviewees. Results At the time of interview, the mean age of children and care-givers was 17 (15–19) and 47 (21–70) years old, respectively. Many care-givers had lost family members due to HIV and several were HIV positive themselves. Reasons for non-disclosure included fear of stigmatisation; wanting to protect the child and not having enough knowledge about HIV or the status of the child to disclose. Several children had multiple care-givers, which also delayed disclosure, as responsibility for the child was shared. In addition, some care-givers were struggling to accept their own HIV status and did not want their child to blame them for their own positive status by disclosing to them. Conclusions Child disclosure is a complex process for care-givers, health-care workers and the children themselves. Care-givers may require additional psycho-social support to manage disclosure. Involving multiple care-givers in the care of HIV positive children could offer additional support for disclosure. | en_US |
| dc.identifier.apacitation | Sumbi, E. M., Venables, E., Harrison, R., Garcia, M., Iakovidi, K., van Cutsem, G., & Chalachala, J. L. (2021). “It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo. <i>BMC Public Health</i>, 21(Article number: 313), http://hdl.handle.net/11427/35192 | en_ZA |
| dc.identifier.chicagocitation | Sumbi, Elysée M, Emilie Venables, Rebecca Harrison, Mariana Garcia, Kleio Iakovidi, Gilles van Cutsem, and Jean L Chalachala "“It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo." <i>BMC Public Health</i> 21, Article number: 313. (2021) http://hdl.handle.net/11427/35192 | en_ZA |
| dc.identifier.citation | Sumbi, E.M., Venables, E., Harrison, R., Garcia, M., Iakovidi, K., van Cutsem, G. & Chalachala, J.L. 2021. “It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo. <i>BMC Public Health.</i> 21(Article number: 313) http://hdl.handle.net/11427/35192 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Sumbi, Elysée M AU - Venables, Emilie AU - Harrison, Rebecca AU - Garcia, Mariana AU - Iakovidi, Kleio AU - van Cutsem, Gilles AU - Chalachala, Jean L AB - Background It is estimated that 64,000 children under 15 years of age are living with HIV in the Democratic Republic of Congo (DRC). Non-disclosure – in which the child is not informed about their HIV status - is likely to be associated with poor outcomes during adolescence including increased risk of poor adherence and retention, and treatment failure. Disclosing a child’s HIV status to them can be a difficult process for care-givers and children, and in this qualitative study we explored child and care-giver experiences of the process of disclosing, including reasons for delay. Methods A total of 22 in-depth interviews with care-givers and 11 in-depth interviews with HIV positive children whom they were caring for were conducted in one health-care facility in the capital city of Kinshasa. Care-givers were purposively sampled to include those who had disclosed to their children and those who had not. Care-givers included biological parents, grandmothers, siblings and community members and 86% of them were female. Interviews were conducted in French and Lingala. All interviews were translated and/or transcribed into French before being manually coded. Thematic analysis was conducted. Verbal informed consent/assent was taken from all interviewees. Results At the time of interview, the mean age of children and care-givers was 17 (15–19) and 47 (21–70) years old, respectively. Many care-givers had lost family members due to HIV and several were HIV positive themselves. Reasons for non-disclosure included fear of stigmatisation; wanting to protect the child and not having enough knowledge about HIV or the status of the child to disclose. Several children had multiple care-givers, which also delayed disclosure, as responsibility for the child was shared. In addition, some care-givers were struggling to accept their own HIV status and did not want their child to blame them for their own positive status by disclosing to them. Conclusions Child disclosure is a complex process for care-givers, health-care workers and the children themselves. Care-givers may require additional psycho-social support to manage disclosure. Involving multiple care-givers in the care of HIV positive children could offer additional support for disclosure. DA - 2021-02-06 DB - OpenUCT DP - University of Cape Town IS - Article number: 313 J1 - BMC Public Health KW - Children KW - Democratic Republic of Congo KW - HIV care continuum KW - Disclosure KW - Qualitative research LK - https://open.uct.ac.za PY - 2021 T1 - “It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo TI - “It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo UR - http://hdl.handle.net/11427/35192 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12889-021-10327-5 | |
| dc.identifier.uri | http://hdl.handle.net/11427/35192 | |
| dc.identifier.vancouvercitation | Sumbi EM, Venables E, Harrison R, Garcia M, Iakovidi K, van Cutsem G, et al. “It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo. BMC Public Health. 2021;21(Article number: 313) http://hdl.handle.net/11427/35192. | en_ZA |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Department of Public Health and Family Medicine | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | BMC Public Health | en_US |
| dc.source.journalissue | Article number: 313 | en_US |
| dc.source.journalvolume | 21 | en_US |
| dc.source.uri | https://bmcpublichealth.biomedcentral.com/ | |
| dc.subject | Children | en_US |
| dc.subject | Democratic Republic of Congo | en_US |
| dc.subject | HIV care continuum | en_US |
| dc.subject | Disclosure | en_US |
| dc.subject | Qualitative research | en_US |
| dc.title | “It’s a secret between us”: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo | en_US |
| dc.type | Journal Article | en_US |