title: Breaking down the wall of silence around children affected by AIDS in Thailand to support their psychosocial health.
abstract: This study examines the psychosocial needs of the children affected by AIDS. Eight primary school children aged 10-13 years who lost parents to AIDS or whose parents were living with HIV were closely followed for a period of one year and qualitative data on the psychosocial challenges they faced were collected using semi-structured interviews, observation, drawings and diaries. Data were also collected from their caregivers and classroom teachers using semi-structured interviews, as well as data from their classmates using a self-completion questionnaire. The findings strongly suggested that adults were creating a "wall of silence" around children affected by AIDS by hiding the parents' HIV status from them and avoid talking to them about HIV and AIDS. The silence was intended to protect the children from sadness, embarrassment, bullying and discrimination. In reality, however, the silence was found to have isolated them and increased their psychosocial vulnerability by blocking open communication with family members, peers and teachers, and left them to cope with their problems on their own. It is argued that to support the psychosocial health of these children, it is necessary for the adults to recognise the negative impact of silence and for the families and the school to be involved in a process of participatory learning and action to find culturally appropriate ways to break down the wall of silence, and promote more open communication.
authors.affiliation: Bureau of International Cooperation, International Medical Center of Japan, Tokyo, Japan. n-ishikawa@it.imcj.go.jp
authors.forename: Naoko
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Pat
authors.initials: P
authors.lastname: Pridmore
authors.forename: Roy
authors.initials: R
authors.lastname: Carr-Hill
authors.forename: Kreangkrai
authors.initials: K
authors.lastname: Chaimuangdee
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002669:Child Welfare / Q000523:psychology*; D016241:Child of Impaired Parents / Q000523:psychology*; D003144:Communication Barriers; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D013240:Stereotyping; D013315:Stress, Psychological; D013334:Students / Q000523:psychology; D013785:Thailand / Q000453:epidemiology; D014342:Truth Disclosure