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‘Are we allowed to disclose?’

A healthcare team's experiences of talking with children and adolescents about their HIV status

Bibliographic Data

ID19507115
AuthorsJennifer Watermeyer (0000-0001-7918-8832, Health Communication Research Unit School of Human and Community Development University of the Witwatersrand Johannesburg South Africa, corresponding author)
Year2015
Volume18
Issue4
Pages590-600
Publication date2015-08-01
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.12141
PMID24112299
OpenAlexW2114416912
LanguageEN
Citations received9
References cited26

BACKGROUND: Talking with a child about their HIV status is a complex, emotionally laden and difficult task for caregivers and healthcare providers. Disclosure is an important process which may have psychosocial and health benefits. Despite existing guidelines and materials, disclosure does not always happen for various reasons. OBJECTIVE: This qualitative study explored a healthcare team's perspectives and experiences about disclosure practices. METHODS: Three focus groups were conducted with a total of 23 healthcare providers at a paediatric clinic in South Africa. The data were analysed using principles of thematic analysis. RESULTS: Results confirm the complexity of the disclosure process and highlight confusion, hesitancy and ethical dilemmas regarding disclosure practices. Tensions were noted within the team which seem linked to professional hierarchies. Counsellors and nurses preferred an indirect approach of encouraging caregivers to disclose to their children and providing psychosocial support, while doctors tended to become more directly involved in disclosing to children out of a sense of duty, legal responsibilities and knowledge of the child's rights. DISCUSSION AND CONCLUSIONS: This study demonstrates how the complexities of disclosure with children and adolescents bring about additional challenges for healthcare teams. The legal and ethical implications as well as the roles and responsibilities of healthcare providers with disclosure remain unclear. Several recommendations for practice and policy emerge from this study, related particularly to the need for clarification of disclosure guidelines and legal implications. Implications for the healthcare team are also discussed

Business · Duty · Focus group · Health care · Medical education · Political science · Psychiatry · Psychosocial · Qualitative research · Sociology · Thematic analysis · Adolescent Sexual and Reproductive Health · Ethics and Legal Issues in Pediatric Healthcare · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology

  • Everyone has a secret they keep close to their hearts’

    Open Access•A Abubakar, Fons J R Van De Vijver et al.•BMC Public Health•2016

  • A Phenomenological Account of HIV Disclosure Experiences of Children and Adolescents from Northern and Southern Ghana

    Open Access•Seth Christopher Yaw Appiah, Inge Kroidl et al.•International Journal of…•2019

  • The Consequences of Delaying Telling Children with Perinatal HIV About Their Diagnosis as Perceived by Healthcare Workers in the Eastern Cape; A Qualitative Study

    Open Access•Sphiwe Madiba, Cynthia Diko•Children•2020

  • Experiences with disclosure of HIV-positive status to the infected child”

    Open Access•Adellah Sariah, Joan Rugemalila et al.•BMC Public Health•2016

  • Counsellors’ experiences of HIV status disclosure to children living with HIV in Uganda

    Harriet Opondo, Natalya A Lindo et al.•British Journal of Guidance and…•2023

  • How does learning one’s HIV status relate to viral suppression? an analysis among perinatally infected adolescents and young adults in Ndola, Zambia

    Open Access•Christiana Frimpong, Virginia M Burke et al.•Vulnerable Children and Youth…•2021

  • Comunicação do diagnóstico de infecção pelo HIV

    Open Access•Érika Eberline Pacheco dos Santos, Aline Cammarano Ribeiro et al.•Revista Bioética•2021

  • I’m angry with my mother ”

    Ngwashesenge Francinah Malungani, Melitah Molatelo Rasweswe et al.•Journal of Psychology in Africa•2021

  • ‘Too much for one day’

    Open Access•Claire Penn•Health Expectations•2015

  • Disclosure of an HIV Diagnosis to Children

    Lori Wiener, Claude Ann Mellins et al.•Journal of Developmental &…•2007

  • ‘Too much for one day’

    Open Access•Claire Penn•Health Expectations•2015

  • “Now here come the pills that are going to save your life”

    Jennifer Watermeyer•AIDS Care•2011

  • Experiences of families caring for an HIV-infected child in KwaZulu-Natal, South Africa

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    Anthea Lesch, L Swartz et al.•AIDS Care•2007

  • Changing methods of disclosure. Literature review of disclosure to children with terminal illnesses, including HIV

    G Anita Heeren•Innovation The European Journal…•2011

  • Factors Related to HIV Disclosure in 2 South African Communities

    Amy Norman, Mickey Chopra et al.•American Journal of Public Health•2007

  • Using thematic analysis in psychology

    Open Access•Braun, Virginia Braun et al.•Qualitative Research in Psychology•2006

  • Ritual and the organisation of care in primary care clinics in Cape Town, South Africa

    Open Access•Simon Lewin, John Green et al.•Social Science & Medicine•2009

Citations per year0.82
Citation span2015 - 2023 (9)
Highly citedNo

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