AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #235 - Baseline and follow-up results in regards to disclosure of HIV status among HIV+ parents living in Zimbabwe after participation in a coping intervention (PIP) Phase II comparative effectiveness trial.
Authors: Presenting Author: Dr. April Greek - Battelle
Additional Authors: Dr. Danuta Kasprzyk, Dr. Sally Nyandiya Bundy, Dr. Daniel Montano, Mr. Tinashe Muromo, Ms. Norest Beta, Ms. Rachel Gatsi, Mr. Stephen Machokoto,
Aim: The Parent Intervention Programme [PIP] was implemented and tested among a cohort of 400 Zimbabwean families. A Phase II Comparative Effectiveness Trial (CET) examined effects of the intervention via an accrued cohort of HIV+ parents and their adolescent children. The assessment included measures of disclosure. One of the goals of PIP is to encourage parents to disclose their HIV status to families, including children, and friends or others. Research shows HIV+ individuals are often reluctant to disclose results expecting negative reactions.
Method / Issue: 1,007 individuals provided Baseline results, 479 parents and 528 children. 92% 6-month follow-up rates were achieved. An adult Health and Symptom Assessment (HSA), and Psychosocial Assessment (PSA) measured demographics, health status, symptoms, health services use, substance use, sexual risk, self-efficacy, self worth, family functioning, communication, discipline styles and interactions, stress, depression, anxiety, worry, feelings, QOL, social support, HIV knowledge, and disclosure of HIV status.
Results / Comments: The 5th PIP coping session focused on disclosure of HIV status, teaching parents to determine a safe choice for disclosing, and learning how to cope and manage reactions and results of disclosure. Contrary to expectations from formative research, we found high disclosure rates at Baseline: 92% of index parents had disclosed to at least one person with no significant differences across groups (92% coping; 90% capacity, p=.531). Most disclosed to female relatives/friends. Of those disclosing, 24% disclosed to mother; but not mother-in-law (4%); 40% told sisters; 35% told daughters, 27% sons; 64% who had spouses disclosed results. There were no significant differences between coping and capacity arms in the % distributions of disclosure report by category of recipient. At 6-months, % distribution by recipient showed coping participants were more likely to report that they had disclosed to their sister (60% coping; 46% capacity, p=0.16) and to other female friends (24% coping & 11% capacity, p=.005). Between the baseline and 6-month surveys, respondents disclosed results to on average 2 new categories of persons (2.54 coping & 2.12 capacity, p=.053). Disclosure to spouses jumped to 87% at 6-months, with no difference between arms. Adults in the coping arm reported feeling significantly better and safer about the idea of talking to family, all children ages 15-18 and older, about being HIV+ vs. those in the capacity arm who did not (p<.05). Parents from the coping vs. the capacity arms felt it was easier and less upsetting to think about the idea of disclosing to children (all age groups) (p<.05). At the 6-month follow-up, 96% had told someone of their results (98% coping; 93% capacity; p=.061). Of persons who had not disclosed at baseline (n=26), 65% had told someone by the 6-month follow-up (77% coping & 54% capacity, p=.216).
Discussion: Our results showed parents can be taught to safely disclose HIV+ status, and receive support, rather than censure from family members or friends after disclosure. That both coping and capacity interventions had HIV+ parents gathering over many sessions may have encouraged disclosure among individuals in both arms. Additional follow-ups will show if parents achieve more social support through disclosure.
Go Back