title: Predictors of Disclosure of Maternal HIV Status by Caregivers to their Children in an Inner-City Community in the United States.
abstract: Disclosure of HIV status to children is a challenge parents living with HIV face. To evaluate predictors of maternal HIV disclosure in a low-income clinic in the U.S. that serves an African American, Hispanic and immigrant population with high HIV prevalence, 172 caregivers with 608 children completed a standardized survey. Caregivers were 93 % female, 84 % biological mothers, and 34 % foreign born. Sixty-two (36 %) caregivers had at least one disclosed child, 42 of whom also had other nondisclosed children. Of all children, 581 (96 %) were uninfected and 181 (30 %) were disclosed. Caregiver's U.S. birth (OR: 2.32, 95 % CI 1.20-4.52), child's age (OR: 1.2/year, 95 % CI 1.16-1.24), and increased HIV-stigma perception by caregiver (1.06/point increase, 95 % CI 1.04-1.09) predicted disclosure. Children were more often disclosed if their caregiver was born in the U.S. or reported higher HIV-related stigma. These findings suggest that complex family context may complicate disclosure, particularly among immigrants.
authors.affiliation: Columbia University, Mailman School of Public Health, Environmental Health Department, New York, NY, USA. rozanabdul@gmail.com.
authors.forename: Rozan
authors.initials: R
authors.lastname: Abdulrahman
authors.affiliation: Bronx-Lebanon Hospital Center, Department of Pediatrics, Bronx, NY, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Stuard
authors.affiliation: Bronx-Lebanon Hospital Center, Department of Pediatrics, Bronx, NY, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Vachon
authors.affiliation: Bronx-Lebanon Hospital Center, Department of Pediatrics, Bronx, NY, USA.
authors.forename: Cate
authors.initials: C
authors.lastname: Nicholas
authors.affiliation: Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Neugebauer
authors.affiliation: Bronx-Lebanon Hospital Center, Department of Pediatrics, Bronx, NY, USA.
authors.forename: Stefan H F
authors.initials: SH
authors.lastname: Hagmann
authors.affiliation: Bronx-Lebanon Hospital Center, Department of Pediatrics, Bronx, NY, USA.
authors.forename: Murli U
authors.initials: MU
authors.lastname: Purswani
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D030881:Disclosure; D054242:Emigrants and Immigrants; D005260:Female; D015658:HIV Infections; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers; D010290:Parents; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population; D055815:Young Adult
keywords: Children; Disclosure; HIV; HIV-exposed, uninfected (HEU); Maternal HIV status; Stigma