scholarly journals A Couple’s Marital Disharmony and its Psychological Effects on their Children during the HIV Disclosure Process in Kenya

2015 ◽  
Vol 8 (1) ◽  
pp. 34-47 ◽  
Author(s):  
G. Gachanja
Keyword(s):  
Hiv Testing ◽  
Lived Experiences ◽  
Hiv Disclosure ◽  
Psychological Effects ◽  
Hiv Positive ◽  
Published Data ◽  
Structured Interviews ◽  
Full Disclosure ◽  
The Family

Limited published data exists on how HIV-positive parents perform disclosure to all their children. A couple’s HIV disclosure experience to all their children is presented. They participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process. Each underwent individualized in-depth semi-structured interviews. Interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and post-disclosure psychological effects on the family. Marital disharmony and non-involvement of the father caused the mother to fully disclose their illnesses to their four oldest children. All children were affected by disclosure, one had a delayed emotional outburst, and another was still angry and withdrawn years later. HIV-positive parents with poor relationships within the families need intense counseling and support pre, during, and post-disclosure to improve outcomes. 

scholarly journals A couple’s marital disharmony and its psychological effects on their children during the HIV disclosure process in Kenya

2014 ◽  
Author(s):  
Grace Gachanja
Keyword(s):  
Hiv Testing ◽  
Family Cohesion ◽  
Structured Interview ◽  
Hiv Disclosure ◽  
Psychological Effects ◽  
Hiv Positive ◽  
Published Data ◽  
Full Disclosure ◽  
The Family ◽  
Gap Data

HIV-positive parents are challenged with disclosure to their children. Limited published data exists on how HIV-positive parents perform disclosure to all their children in the household. To start addressing this gap, data is presented on a couple’s HIV disclosure experiences to all their children. The couple participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Each underwent an individualized in-depth semi-structured interview. Their interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and post-disclosure psychological effects on the family. The couple’s narration of their diagnoses, and disclosure experiences to their children differed significantly. Ongoing poor paternal health caused persistent inquisitive questions from children. A poor paternal-children relationship, accompanied with his avoidance and non-involvement in disclosure matters caused the mother to fully disclose both parents’ illnesses to the four oldest children. These children were affected by disclosure and held animosity towards their father. One had an emotional outburst directed at the father, while another still displayed anger and withdrawal years later. Therefore, the couple was hesitant to fully disclose their illnesses to their youngest son and differed in how they wanted to disclose to him. HIV-positive parents with poor relationships among family members before HIV testing and/or disclosure should be provided with intense counseling aimed at increasing family cohesion. Extra support before, during, and after disclosure may be required for these families to increase positive outcomes.

scholarly journals A couple’s marital disharmony and its psychological effects on their children during the HIV disclosure process in Kenya

2014 ◽  
Author(s):  
Grace Gachanja
Keyword(s):  
Hiv Testing ◽  
Family Cohesion ◽  
Structured Interview ◽  
Hiv Disclosure ◽  
Psychological Effects ◽  
Hiv Positive ◽  
Published Data ◽  
Full Disclosure ◽  
The Family ◽  
Gap Data

HIV-positive parents are challenged with disclosure to their children. Limited published data exists on how HIV-positive parents perform disclosure to all their children in the household. To start addressing this gap, data is presented on a couple’s HIV disclosure experiences to all their children. The couple participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Each underwent an individualized in-depth semi-structured interview. Their interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and post-disclosure psychological effects on the family. The couple’s narration of their diagnoses, and disclosure experiences to their children differed significantly. Ongoing poor paternal health caused persistent inquisitive questions from children. A poor paternal-children relationship, accompanied with his avoidance and non-involvement in disclosure matters caused the mother to fully disclose both parents’ illnesses to the four oldest children. These children were affected by disclosure and held animosity towards their father. One had an emotional outburst directed at the father, while another still displayed anger and withdrawal years later. Therefore, the couple was hesitant to fully disclose their illnesses to their youngest son and differed in how they wanted to disclose to him. HIV-positive parents with poor relationships among family members before HIV testing and/or disclosure should be provided with intense counseling aimed at increasing family cohesion. Extra support before, during, and after disclosure may be required for these families to increase positive outcomes.

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 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-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.

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. The purpose of the study was 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 completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at fiveyears 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 considerations at the time of full disclosure included the parent’s and/or child’s health statuses, number of infected family members’ illnesses to be disclosed to the child, child’s maturity and understanding level, and the person best suited to deliver full disclosure to the child. The results also revealed it was important to address important life events such as taking a national school examination during disclosure planning and delivery. Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs in resource-poor nations with high HIV prevalence.

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. The purpose of the study was 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 completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at fiveyears 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 considerations at the time of full disclosure included the parent’s and/or child’s health statuses, number of infected family members’ illnesses to be disclosed to the child, child’s maturity and understanding level, and the person best suited to deliver full disclosure to the child. The results also revealed it was important to address important life events such as taking a national school examination during disclosure planning and delivery. Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs in resource-poor nations with high HIV prevalence.

scholarly journals Preparing for the delivery of PrEP: Lessons from the implementation of integrated reproductive health and HIV services in Kenya

2020 ◽  
Author(s):  
Emily McDonald Evens ◽  
Theresa Hoke ◽  
Margaret Eichleay ◽  
Patrick Olsen ◽  
Alice Olawo ◽  
...  
Keyword(s):  
Service Delivery ◽  
Hiv Testing ◽  
Integrated Services ◽  
Health Service Delivery ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Outpatient Services ◽  
Structured Interviews ◽  
Tuberculosis Screening ◽  
Exposure Prophylaxis

Abstract Background: In 2015, the WHO issued guidelines recommending oral pre-exposure prophylaxis (PrEP) for individuals at substantial risk of HIV. Given their role in health service delivery, ministries of health are assuming major responsibility for PrEP services in sub-Saharan Africa. However, these are often strained and under-resourced. We measured the delivery of selected integrated services and identified the factors that impede effective delivery of integrated services to prepare for the integration of PrEP into health services for women. Methods: Three services were examined: 1) HIV testing within family planning, 2) HIV testing within general outpatient services, and 3) care and prevention services for HIV-positive clients not eligible for antiretrovirals (“Pre-ART”). Descriptive, mixed-methods research was conducted in three Kenyan counties using: service delivery observations (n = 3246) and client exit interviews (n = 3257) in public facilities, and semi-structured interviews with providers, managers and officials (n = 112). Results: Integrated services were not consistently implemented. HIV testing was not systematically offered or received; most clients were not aware testing was available, and tests were largely unavailable. Pre-ART services did not systematically deliver mandated services. Rates of cervical cancer and tuberculosis screening were especially low; a concerning gap given the elevated risk for HIV-positive women. Supply-side challenges of staffing, infrastructure and commodity shortages were common. Conclusions: In an era of significant demands on treatment resources and decreasing funding for prevention, the identification of the technical, material, and human resources required for successful and sustainable delivery of integrated services must be addressed to support successful PrEP implementation. Key words: Pre-exposure prophylaxis, Kenya, Integrated health, HIV

scholarly journals HIV-positive parents’ accounts on disclosure preparation activities for a parent’s and/or a child’s illness in Kenya

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

The aim of this research brief is to describe a study that examined how HIV-positive parents prepared themselves and their children for HIV disclosure in Kenya. This is the first study from Sub-Saharan Africa (SSA) that provides comprehensive data on how HIV-positive parents prepare themselves and their HIV-positive and negative children for disclosure of a parent’s and/or a child’s illness. Prior studies in SSA have provided limited details about the activities performed by parents to prepare for disclosure of a parent’s or a child’s illness. Key aspects of preparing for disclosure to children: 1. Most parents take years to prepare for disclosure, proceeding when they judge themselves ready to impart the news and their children receptive to receive the news. 2. Parents’ preparation activities for disclosure proceed through four major phases which include secrecy, exploration, readiness, and finally full disclosure of illness. 3. In the secrecy phase parents do not disclose; in the exploration phase they plan how they will disclose; in the readiness phase they seek activities that will help them to fully disclose; finally when ready they fully disclose to their children based on birth order. 4. Parents who have many children remain simultaneously within the different preparation phases as they move their children from a state where none are disclosed to, to a state when all of them have been fully disclosed to. The original research article is located at: http://scholarworks.waldenu.edu/jsbhs/vol8/iss1/1/

scholarly journals The Lived Experiences of Parents of Iranian Young Women with Multiple Sclerosis

2019 ◽  
Author(s):  
Marzieh Panahi ◽  
Zahra Tazakori ◽  
Mansoureh Karimollahi
Keyword(s):  
Multiple Sclerosis ◽  
Young Women ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Positive Impact ◽  
Structured Interviews ◽  
The Family ◽  
Data Saturation ◽  
Open Coding ◽  
Colaizzi's Method

Abstract Background: Chronic illness in children causes more mental health risks for parents than other members of the family. Therefore, exploring the experiences of parents living with young women who have multiple sclerosis and presenting them to healthcare planners and managers can have a positive impact on community health. This study aimed to explore the experiences of parents of young women with multiple sclerosis in Iran. Methods: This research was a phenomenological study, and sampling was continued until data saturation, and 12 participants were chosen. The data were gathered using semi-structured interviews and analyzed using Colaizzi's method. Results: Open coding resulted in 450 codes, and after several stages of analysis and integration of similar codes, five main concepts, and 21 sub-concepts was produced. The main concepts included distress, trapping, adaptation barriers, response to illness, and reconciliation with the disease. Conclusion: This study showed the disease affects all dimensions of the parents' life and can lead to the experiences that are new to them and may lead to confusion. These findings can lead to more effective parental care for their daughters. It can also reduce the burden of disease on the family, the health system, and the community.

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