scholarly journals A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya

2015 ◽  
Author(s):  
Grace Gachanja
Keyword(s):  
Rapid Assessment ◽  
Hiv Disclosure ◽  
Hiv Positive ◽  
School Aged Children ◽  
Stigma And Discrimination ◽  
Medication Consumption ◽  
Acceptance Of Illness ◽  
Watching Tv ◽  
Feeling Overwhelmed ◽  
Hiv Negative

There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIVpositive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIVnegative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an indepth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak with for social support. When feeling overwhelmed by their circumstances, most children self-withdrew and performed positive activities (e.g., praying, watching TV, listening to the radio, singing, dancing) to help themselves feel better. Many HIV-affected families have a combination of HIV-positive and negative siblings within the household. Pending further studies conducted with larger sample sizes, the results of this study should assist healthcare professionals to better facilitate disclosure between HIV-positive parents and their children of mixed HIV statuses.

scholarly journals A rapid assessment of post-disclosure experiences of urban HIV-positive and HIV-negative school-aged children in Kenya

2015 ◽  
Author(s):  
Grace Gachanja
Keyword(s):  
Rapid Assessment ◽  
Hiv Disclosure ◽  
Hiv Positive ◽  
School Aged Children ◽  
Stigma And Discrimination ◽  
Medication Consumption ◽  
Acceptance Of Illness ◽  
Watching Tv ◽  
Feeling Overwhelmed ◽  
Hiv Negative

There has been limited involvement of HIV-negative children in HIV disclosure studies; most studies conducted on the effects of disclosure on children have been with HIVpositive children and HIV-positive mother-child dyads. Seven HIV-positive and five HIVnegative children participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. In this study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an indepth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data, indicating that HIV-positive and negative children appear to have differing post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. Following disclosure, HIV-negative children accepted their parents’ illnesses within a few hours to a few weeks; HIV-positive children took weeks to months to accept their own illnesses. HIV-negative children knew of high levels of stigma and discrimination within the community; HIV-positive children reported experiencing indirect incidences of stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees so they could have a better life in the future; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. All but one preadolescent HIV-positive child had self-identified a person to speak with for social support. When feeling overwhelmed by their circumstances, most children self-withdrew and performed positive activities (e.g., praying, watching TV, listening to the radio, singing, dancing) to help themselves feel better. Many HIV-affected families have a combination of HIV-positive and negative siblings within the household. Pending further studies conducted with larger sample sizes, the results of this study should assist healthcare professionals to better facilitate disclosure between HIV-positive parents and their children of mixed HIV statuses.

scholarly journals A rapid assessment of HIV post-disclosure experiences of urban school-aged children in Kenya

2015 ◽  
Author(s):  
Grace Gachanja
Keyword(s):  
Rapid Assessment ◽  
Hiv Disclosure ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
School Aged Children ◽  
Stigma And Discrimination ◽  
Medication Consumption ◽  
Sub Saharan ◽  
Acceptance Of Illness ◽  
Hiv Negative

Some HIV affected families in Kenya have a combination of HIV-positive and negative children within the household. HIV-positive and negative children are known to experience variable effects following disclosure of their own and their parents’ illnesses respectively. Most studies conducted on the effects of disclosure on children have been with HIV-positive children and mother-child dyads. There has been limited involvement of HIV-negative children in HIV disclosure studies in Sub-Saharan Africa. A larger study was conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Seven HIV-positive and five HIV-negative children participated in that study. In the current study, the experiences of these 12 children after receiving disclosure of their own and their parents’ illnesses respectively are presented. Each child underwent an in-depth qualitative semi-structured digitally recorded interview. The recorded interviews were transcribed and loaded into NVivo8 for phenomenological data analysis. Five themes emerged from the data showing that HIV-positive and negative children have varying post-disclosure experiences revolving around acceptance of illness, stigma and discrimination, medication consumption, sexual awareness, and use of coping mechanisms. HIV-negative children accepted their parents’ illnesses faster than HIV-positive children accepted their own illnesses; the later also reported facing more stigma and discrimination. HIV-negative children wanted their parents to take their medications, stay healthy, and pay their school fees; HIV-positive children viewed medication consumption as an ordeal necessary to keep them healthy. HIV-negative children wanted their parents to speak to them about sexual-related matters; HIV-positive children had lingering questions about relationships, use of condoms, marriage, and childbearing options. The majority of children coped by speaking about their circumstances to a person close to them and also self-withdrawing to be by themselves when feeling overwhelmed. Pending further studies conducted with larger sample sizes, the results of this study can be used by healthcare professionals to better facilitate disclosure between HIV-positive parents and their children of mixed HIV statuses.

scholarly journals Clinical features and para-clinical findings of cryptococcal meningitis in the North of Iran during 2011-19

2021 ◽  
Author(s):  
Farhang Babamahmoodi ◽  
Kobra Gerizade firozjaii ◽  
Masoumeh Bayani ◽  
Tahereh Shokohi ◽  
Jamshid Yazdani ◽  
...  
Keyword(s):  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Underlying Disease ◽  
Clinical Findings ◽  
Hiv Positive ◽  
The North ◽  
Medication Consumption ◽  
Significant Difference ◽  
North Of Iran ◽  
Hiv Negative

Background and Purpose:Cryptococcalmeningitis (CM) is a serious fungal infection that especially affectspatients with human immunodeficiency virus (HIV). In this regard,the present retrospective study aimed to analyze the clinical and laboratory features and therapeutic outcomes of patients with CM admitted to two teaching referral centersin the north of Iran during 2011-19. Materials and Methods:This study was performed onall the hospitalized patients diagnosed with CM in two therapeutic centers of infectious diseases in the north of Iran. The required data,such as demographic characteristics and clinical and paraclinical features of patients, were extracted and entered in the information forms. Finally, the collected data were analyzed inSPSSsoftware(version16). Results:For the purpose of the study, records of 12confirmed CM patients were evaluatedin this research. Based on the results,75% of the patients were male. Moreover,the average age of the subjects was 40.33± 8.93 years old and 66.6%ofthem(n=8) were HIV-positive. Other underlying diseases among HIV-positive patients included infection with hepatitis C virus (25%) and a history of tuberculosis (25%). In total, threeHIV-negative patients suffered from Hodgkin lymphoma (25%), sarcoidosis (25%),and asthma (25%) and one patient (25%) had no underlying disease. Headache (75%), weakness,and fatigue (75%) were the most common symptoms among the participants. The cluster of differentiation 4count in all HIV-positive patients was less than 100 cells/μl. There was no significant difference between symptoms in HIV-positive and HIV-negative patients. Besides, no significant difference was observed between the groups of HIV-positive and HIV-negative patients regarding the period between the onset of symptoms and diagnosis of CM,the length of hospital stay,and the duration of antifungal medication consumption. In total,three patients (25%) expired,and six patients recovered. The CM recurred in two HIV-negative and oneHIV-positive subjects;the two HIV-negative patients were treated,whilethe HIV-positive patient expired due to this recurrence. Conclusion:Clinical features and cerebrospinal fluid parameters were not different in HIV-positive and HIV-negative participants. Despite the fact thatCM is not common in Iran, due to the increasing number of immunosuppressive patients, the differential diagnosis of CM should be considered for patients with signs and symptoms of infection in the central nervous system.

scholarly journals HIV disclosure perspectives from HIV-positive parents, HIV-positive children, and HIV-negative children

2014 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro
Keyword(s):  
Good Health ◽  
Hiv Disclosure ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Original Research ◽  
Research Article ◽  
Sub Saharan ◽  
Key Aspects ◽  
Hiv Negative

The aim of this research brief is to describe a study that examined the lived experiences of HIV-positive parents and their biological HIV-positive and negative children before, during, and after the HIV disclosure process in Kenya. This is the first study from Sub-Saharan Africa (SSA) that provides perspectives on HIV disclosure of a parent’s and a child’s illness from the viewpoints of HIV-positive parents, HIV-positive children, and HIV-negative children. Prior studies in SSA have mostly centered on disclosure to HIV-positive children (of their own illnesses) and others have reported on parents disclosing their illnesses to their children. Key Aspects of HIV Disclosure to Children: 1. Disclosure should be performed as a process. 2. It is a parent’s decision on when to disclose but also a child’s right to be told about his/her own, a parent’s, and other family member’s illnesses and deaths. 3. Healthcare professionals should help parents prepare for and disclose family member’s illnesses and prior deaths to their children. 4. Disclosure should preferably be performed when both the parent and child are in good health. 5. Disclosure should be performed when a child shows understanding of the illness and/or maturity. 6. Disclosure planning should include a determination of who is the most suitable person to disclose to a child. 7. Disclosure should be postponed until animportant life event (e.g., taking a national school examination) has occurred. The original research article is located at: https://peerj.com/articles/486.pdf

scholarly journals Parents' phases and children's stages of HIV disclosure

2016 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro
Keyword(s):  
Phenomenological Study ◽  
Hiv Disclosure ◽  
Hiv Positive ◽  
Structured Interviews ◽  
Full Disclosure ◽  
Unknown Status ◽  
Living Children ◽  
Qualitative Phenomenological ◽  
Qualitative Phenomenological Study ◽  
Hiv Negative

Background: HIV-positive parents are challenged with disclosure to their children. Some do not disclose at all, others disclose to some children, and many take years to fully disclose to all their children. Methods: This qualitative phenomenological study was conducted in Kenya to describe the lived experiences of HIV-positive parents and their children during the disclosure process. Sixteen HIV-positive parents were engaged in in-depth, semi-structured interviews. Interview data were analyzed using the modified Van Kaam method. Results: Parents had a total of 37 living children; 15 HIV-positive, 11 HIV-negative, and 11 of unknown HIV status. Parents went through four phases (secrecy, exploratory, readiness, full disclosure) of disclosure; most admitted needing healthcare professionals’ help to move their children through the three child stages (no, partial, full) of disclosure . Most parents were in between the exploratory and full disclosure phases but had taken years to navigate these phases. Twelve children (HIV-negative and unknown status) had full disclosure of their parents’ illnesses, nine HIV-positive children had full disclosure of their own and their parents’ illnesses, and 10 children (five HIV-positive, four unknown status, and one HIV-negative) had partial disclosure of their own and/or their parents’ illnesses. Parents had indefinite plans to disclose to the six children with no disclosure. Conclusion: Despite being challenged with disclosure, parents progressively navigated the disclosure phases and fully disclosed to the majority of their children. However, the creation of HIV disclosure guidelines, services, and programs would help hasten the time it takes for them to fully disclose to all their children.

scholarly journals HIV, Human Rights and Migration: Narratives of HIV-Positive Asylum Seekers in Scotland

2021 ◽  
Author(s):  
George Palattiyil ◽  
Dina Sidhva
Keyword(s):  
Human Rights ◽  
Medical Care ◽  
Asylum Seekers ◽  
Community Integration ◽  
Hiv Treatment ◽  
Hiv Disclosure ◽  
Hiv Positive ◽  
Stigma And Discrimination ◽  
Care And Support ◽  
The Uk

AbstractPolitical instability, armed unrest, religious intolerance, human rights violations, ethnic conflict and environmental disasters that threaten one’s life, displace people and often compel them to seek asylum elsewhere. Over the years, the UK has been a major recipient of asylum seekers, some of whom have come to Scotland, especially since 2000, and among these there are a number who present health issues including being HIV-positive. HIV-positive asylum seekers experience poverty, isolation, vulnerability, stigma and discrimination, which when coupled with a lack of appropriate medical care and support, have the potential of adding another layer on the denial of fundamental human rights and further stigmatising people who are already fleeing circumstances threatening their very existence. This paper discusses findings from a recent study that examined the lived experiences of HIV-positive asylum seekers since their arrival in Scotland. A flexible qualitative research design that included in-depth interviews that used life history and a phenomenological approach was adopted. Underpinned by ethics approval, nineteen HIV-positive Black African asylum seekers were recruited through third sector organisations in Glasgow, Scotland. Additional data were gathered from two emotive and discursive focus group meetings. Findings were developed using narrative analysis. The accounts of the asylum seekers reflect continued fear of stigma in the face of HIV disclosure, but also pervasive poverty and inequality. Their experiences include denial of rights to family and security, fear of being detained and deported, denial of appropriate medical care, symptoms of post-traumatic disorder and the culturally insensitive and sometimes inhumane attitude of the UK Immigration Agency. These themes depict an everyday struggle in a context of denial of support and risk of potential deportation to a country where HIV treatment is limited or inaccessible. Their narratives also attest to the life-giving, unstinting care and support they receive from a handful of voluntary agencies and one specialist HIV clinic in Scotland. The findings from this study raise issues for a debate about the treatment of HIV-positive asylum seekers in Scotland. Poverty, inequality, stigma and discrimination continue to pose difficulties in accessing care and treatment and wider community integration. Often treated in a piecemeal and ‘service-siloed’ fashion, the needs and human rights of HIV-positive asylum seekers require a greater, more holistic practice and policy attention.

scholarly journals Parents' phases and children's stages of HIV disclosure

2016 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro
Keyword(s):  
Phenomenological Study ◽  
Hiv Disclosure ◽  
Hiv Positive ◽  
Structured Interviews ◽  
Full Disclosure ◽  
Unknown Status ◽  
Living Children ◽  
Qualitative Phenomenological ◽  
Qualitative Phenomenological Study ◽  
Hiv Negative

Background: HIV-positive parents are challenged with disclosure to their children. Some do not disclose at all, others disclose to some children, and many take years to fully disclose to all their children. Methods: This qualitative phenomenological study was conducted in Kenya to describe the lived experiences of HIV-positive parents and their children during the disclosure process. Sixteen HIV-positive parents were engaged in in-depth, semi-structured interviews. Interview data were analyzed using the modified Van Kaam method. Results: Parents had a total of 37 living children; 15 HIV-positive, 11 HIV-negative, and 11 of unknown HIV status. Parents went through four phases (secrecy, exploratory, readiness, full disclosure) of disclosure; most admitted needing healthcare professionals’ help to move their children through the three child stages (no, partial, full) of disclosure . Most parents were in between the exploratory and full disclosure phases but had taken years to navigate these phases. Twelve children (HIV-negative and unknown status) had full disclosure of their parents’ illnesses, nine HIV-positive children had full disclosure of their own and their parents’ illnesses, and 10 children (five HIV-positive, four unknown status, and one HIV-negative) had partial disclosure of their own and/or their parents’ illnesses. Parents had indefinite plans to disclose to the six children with no disclosure. Conclusion: Despite being challenged with disclosure, parents progressively navigated the disclosure phases and fully disclosed to the majority of their children. However, the creation of HIV disclosure guidelines, services, and programs would help hasten the time it takes for them to fully disclose to all their children.

scholarly journals HIV disclosure perspectives from HIV-positive parents, HIV-positive children, and HIV-negative children

2014 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro
Keyword(s):  
Good Health ◽  
Hiv Disclosure ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Original Research ◽  
Research Article ◽  
Sub Saharan ◽  
Key Aspects ◽  
Hiv Negative

The aim of this research brief is to describe a study that examined the lived experiences of HIV-positive parents and their biological HIV-positive and negative children before, during, and after the HIV disclosure process in Kenya. This is the first study from Sub-Saharan Africa (SSA) that provides perspectives on HIV disclosure of a parent’s and a child’s illness from the viewpoints of HIV-positive parents, HIV-positive children, and HIV-negative children. Prior studies in SSA have mostly centered on disclosure to HIV-positive children (of their own illnesses) and others have reported on parents disclosing their illnesses to their children. Key Aspects of HIV Disclosure to Children: 1. Disclosure should be performed as a process. 2. It is a parent’s decision on when to disclose but also a child’s right to be told about his/her own, a parent’s, and other family member’s illnesses and deaths. 3. Healthcare professionals should help parents prepare for and disclose family member’s illnesses and prior deaths to their children. 4. Disclosure should preferably be performed when both the parent and child are in good health. 5. Disclosure should be performed when a child shows understanding of the illness and/or maturity. 6. Disclosure planning should include a determination of who is the most suitable person to disclose to a child. 7. Disclosure should be postponed until animportant life event (e.g., taking a national school examination) has occurred. The original research article is located at: https://peerj.com/articles/486.pdf

scholarly journals HIV-positive parents, HIV-positive children, and HIV-negative children’s perspectives on disclosure of a parent’s and child’s illness in Kenya

2014 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro
Keyword(s):  
Lived Experiences ◽  
Healthcare Professionals ◽  
Hiv Disclosure ◽  
Hiv Positive ◽  
Full Disclosure ◽  
Children’S Perspectives ◽  
National School ◽  
To Receive ◽  
Depth Interviews ◽  
Hiv Negative

HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. This study was conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children underwent semistructured in-depth interviews. Data was analyzed using the Van Kaam method in NVivo 8. Seven themes emerged that spanned the disclosure process. Presented here is data on the theme about how participants recommend full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at five years with full disclosure delivered at 10 years when the child was capable of understanding the illness; or by 14 years when the child was mature enough to receive the news if full disclosure had not been conducted earlier. Important disclosure considerations include the parent’s and/or child’s health statuses, the number of infected persons’ illnesses to be disclosed to the child, the child’s maturity and understanding level, addressing important life events (e.g., taking a national school examination), and the person best suited to deliver full disclosure to the child. Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs.

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