Parental disclosure of HIV status: Experiences and perceptions of HIV positive parents in Nairobi, Kenya

Thesis (Master's)--University of Washington, 2014Background: Research on parental disclosure of HIV status to children is limited, especially in sub-Saharan Africa where most HIV-infected adults reside. Rates of parental HIV disclosure cited in the literature range from 11-50%. We conducted a mixed methods study to examine rates of parental HIV disclosure and explore factors that influence a parent's decision to disclose their HIV status to their children in Nairobi, Kenya. Methods: Among HIV-infected parents enrolled in the ongoing Counseling and Testing for Children at Home (CATCH) study, we determined rates and cofactors of disclosure of parental HIV status to partners, family members and children. The study recruited HIV-infected adults from HIV treatment clinics and enrolled those who had at least one <12 year old child of unknown HIV status. In addition, in-depth interviews were conducted with 6 parents to ascertain perceived barriers and facilitators of the process of disclosing one's HIV status to one's child and factors that influence the decision to disclose. Results: Among 74 adult participants, median age was 35 years (IQR 32-38) with a median of 5 years since HIV diagnosis; most (84%) were female. Although 77% had disclosed their HIV status to their partner, and 55% to another family member, only 4% had disclosed their HIV status to their child (p