Impact of Disclosure over Time on the Emotional Well-Being of Children with Perinatally Acquired HIV Infection in South Africa.
Janice Buckley, Kennedy Otwombe, Celeste Joyce and 6 others
PMID 34570068WHAT IT FOUND
Gradual HIV disclosure with caregiver support did not appear to worsen emotional well-being over 18 months.
Depression, anxiety, and behavior scores stayed low or decreased; HIV medicine adherence did not change.
Key findings
01Child-reported depression scores were low at baseline and lower at the final assessment.
02Total anxiety and caregiver-reported internalizing and externalizing behavior scores decreased during follow-up.
03Adherence to antiretroviral therapy did not change significantly over the course of the study.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was small, with 30 children enrolled and 28 reported as completing, so it may not show how all children respond. There was no control group, so changes cannot be separated from normal development, ongoing HIV care, counselling, caregiver involvement, or weekly telephone follow-up. Participants were long-standing patients in one clinic, and caregivers seemed motivated and knowledgeable; relationships with staff may have provided security that would not be present elsewhere. Disclosure was spread over 18 months and assessments were 6 weeks after each counselling session, which may have softened any short-term emotional impact. Seven of the 28 participants were disclosed only at the final visit and one did not have full disclosure, so the immediate effect of full disclosure was not evaluated in all children.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read the lower depression and anxiety scores as proof that disclosure itself improves emotional well-being. There was no control group, and the children also received ongoing HIV care, antiretroviral therapy, caregiver-supported counselling, and weekly telephone follow-up, so the contribution of disclosure alone cannot be separated.