title: A Mixed-Methods Study Supporting a Model of Chinese Parental HIV Disclosure.
abstract: Parents who are HIV-positive confront difficult decisions regarding whether, when, and how to disclose their HIV status to their children. In China, a setting of acute HIV stigma where family harmony is culturally valued, limited research has been conducted on parental disclosure. We aimed to develop a model of parental disclosure that accounts for the cultural context in China based on a mixed-methods study. In our individual, in-depth interviews (N = 24) as well as survey data (N = 84) collected from parents living with HIV in Shanghai and Beijing, we found the primary barriers to disclosure were stigma, fear of exposing the mode by which they acquired HIV, psychologically burdening the child, rejection by the child, and negative social consequences for the family. Parents concurrently cited many motivations for disclosure, such as disease progression, ensuring safety of the child, gaining assistance, and fulfilling their parental responsibility. Most parents had not actively disclosed their HIV status (68 %); many parents reported some form of partial disclosure (e.g., sharing they have a blood disease but not labeling it HIV), unplanned disclosure, or unintentional disclosure to their children by other people. Findings informed the development of a Chinese Parental HIV Disclosure Model, with primary components accounting for distal cultural factors, decision-making (balancing approach and avoid motivations), the disclosure event, and outcomes resulting from the disclosure. This model highlights the cultural context of the Chinese parental disclosure process, and may be useful in guiding future observational research and intervention work.
authors: Department of Psychology, University of Washington, Seattle, WA, USA.
authors: Joyce P
authors: JP
authors: Yang
authors: Department of Psychology, Utah State University, Logan, UT, USA.
authors: Tianyi
authors: T
authors: Xie
authors: Department of Psychology, University of Washington, Seattle, WA, USA.
authors: Jane M
authors: JM
authors: Simoni
authors: School of Social Work, University of Washington, Seattle, WA, USA.
authors: Cheng-Shi
authors: CS
authors: Shiu
authors: School of Nursing, Yale University, Orange, CT, USA.
authors: Wei-ti
authors: WT
authors: Chen
authors: Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China. 13911022130@163.com.
authors: Hongxin
authors: H
authors: Zhao
authors: Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China. luhongzhou@fudan.edu.cn.
authors: Hongzhou
authors: H
authors: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012650:Self Disclosure; D057545:Social Stigma; D012944:Social Support; D013315:Stress, Psychological; D014342:Truth Disclosure; D055815:Young Adult
keywords: Children; China; Disclosure; HIV/AIDS; Parents