A model of caregiver paediatric HIV disclosure decision-making

Abstract

Many of the over 3 million HIV-positive children will only be told of their status as adolescents. Knowing one’s status may increase treatment adherence, reduce onward HIV transmission, increase trust in caregivers and maximise available support. Yet deciding whether, what, how and when to tell HIV-positive children about their condition is challenging for caregivers. We systematically review HIV disclosure theories before presenting a process model of caregiver paediatric HIV disclosure decision-making. The model, consisting of both a pre-intention and a post-intention stage, integrates individual and contextual determinants. It aims to be situationally specific, broadly applicable and consistent with the empirical literature. Research and practice implications are discussed.

Keywords:

• paediatric disclosure
• HIV
• caregiver
• decision-making
• model

Acknowledgements

We acknowledge Anthea Lesch and Landon Myer, who both provided feedback on an earlier draft, Amber Wilson for searching the literature and Rosie McGuire for help with the systematic review.

Disclosure statement

No potential conflict of interest was reported by the authors.