The 4 Phases of HIV Disclosure From HIV-positive Parents to their Children
HIV-positive parents are highly challenged with disclosure to their children. The thought of disclosure causes parents to remember the pain they first experienced at the time of their diagnoses and they do not wish to have their children go through the same pain. They therefore push disclosure off to the future until such a time when they are ready to disclose or it becomes imperative that they disclose to their children. I recently blogged here about the phases parents go through until they disclose to their children. Please read that post and familiarize yourself with the phases of HIV disclosure.
I want to revisit the phases of HIV disclosure and also share my recently published paper on how parents performed HIV disclosure preparation of a parent’s and a child’s illness in Kenya. Parents prepared themselves and their children for disclosure by going through the four phases of HIV disclosure.The figure below displays the activities parents performed in each phases as they readied themselves and their children for disclosure. Phases of Disclosure Secrecy Phase: In this phase, parents worked on accepting their illnesses and did not disclose to their children. A few mothers opted to disclose to their children without preparation. One of these children received the news negatively and was suicidal until she received counseling and accepted her illness. This shows children need to be prepared before they are told about theirs and/or their parents’ illnesses. Exploratory Phase: In this phase, parents thought about disclosure constantly and began making disclosure plans. Those who were married decided among themselves how they were going to handle disclosure to the children. Parents also worked on improving their relationships with their children. They read up on the illness and used the knowledge to teach their children about the illness without disclosing.
During the teachings, parents spoke to their children about sex and cleared any misconceptions and stigmatizing views the children had against people with the illness. Parents also tested their children for HIV but mostly only those with signs of illness. It is important to test all children so each one’s HIV status is known and disclosure can then be planned accordingly. Readiness Phase: In this phase, parents felt they were ready to disclose to their children, and the children were ready to receive the news because they were well prepared. In preparation to deliver the news, parents sought counseling for themselves and their HIV-positive children. They attended peer support groups and spoke to other parents about how to disclose, and also took their HIV-positive children to peer support group meetings to mingle with other infected children. Parents also prayed and engaged in religious activities to gain the strength to be able to disclose. Full Disclosure: In this phase, parents fully disclosed to their children by telling their children that the parent and/or child was HIV-positive. Parents disclosed to their children from the oldest going down to the youngest. Those who had many children planned to disclose over a period of time until all their children had been disclosed to. HIV Disclosure Preparation For Yourself and Your Child Parents: HIV disclosure is not easy but it is doable if you prepare yourself well in advance. By looking at the figure above, you can determine what phase of disclosure you are in and plan what activities you need to engage in to prepare yourself and your child for full disclosure. Please also remember to involve your HIV-negative children in disclosure preparation activities (e.g., counseling, support groups) so that they can be prepared to receive the news favorably and recover faster afterwards.
Parents: Please speak to your healthcare provider so you can get advice on the best way to proceed based on your individual family situation. Also visit children’s, teenagers,’ and parents’ at the HIV disclosure blog to find more detailed HIV disclosure information that will help you get ready for this important and necessary step within your family.
Healthcare professionals: Please visit the healthcare professionals’ page where I have also amassed disclosure guidelines and materials from different organizations and countries that will assist you to guide the parents under your care on how to prepare and disclose to their children.
This post was first published at http://www.hivdisclosuretochildren.org
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