title: The role of enacted stigma in parental HIV disclosure among HIV-infected parents in China.
abstract: Existing studies have delineated that HIV-infected parents face numerous challenges in disclosing their HIV infection to the children ("parental HIV disclosure"), and practices of parental HIV disclosure vary with individual characteristics, family contexts, and social environment. Using cross-sectional data from 1254 HIV-infected parents who had children aged 5-16 years in southwest China, the current study examined the association of parental HIV disclosure with mental health and medication adherence among parents and explored the possible effect of enacted stigma on such association. Multivariate analysis of variance revealed that parents who had experienced disclosure to children reported higher level enacted stigma, worse mental health conditions, and poorer medication adherence. Enacted stigma partially mediated the associations between disclosure and both mental health and medication adherence after controlling basic background characteristics. Our findings highlight the importance of providing appropriate disclosure-related training and counseling service among HIV-infected parents. In a social setting where HIV-related stigma is still persistent, disclosure intervention should address and reduce stigma and discrimination in the practice of parental HIV disclosure.
authors.affiliation: a Pediatric Prevention Research Center , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Shan
authors.initials: S
authors.lastname: Qiao
authors.affiliation: a Pediatric Prevention Research Center , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: b Guangxi Center of Disease Control and Prevention , Nanning , China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: b Guangxi Center of Disease Control and Prevention , Nanning , China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: b Guangxi Center of Disease Control and Prevention , Nanning , China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Tang
authors.affiliation: a Pediatric Prevention Research Center , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D057545:Social Stigma; D014342:Truth Disclosure
keywords: ART adherence; HIV disclosure; depression; enacted stigma; parents; stress