title: HIV Status Disclosure through Family-Based Intervention Supports Parenting and Child Mental Health in Rwanda.
abstract: BACKGROUND
  Few evidence-based interventions exist to support parenting and child mental health during the process of caregiver HIV status disclosure in sub-Saharan Africa. A secondary analysis of a randomized-controlled trial was conducted to examine the role of family-based intervention versus usual social work care (care as usual) in supporting HIV status disclosure within families in Rwanda.
  
  
  METHODS
  Approximately 40 households were randomized to family-based intervention and 40 households to care as usual. Parenting, family unity, and child mental health during the process of disclosure were studied using quantitative and qualitative research methods.
  
  
  RESULTS
  Many of the families had at least one caregiver who had not disclosed their HIV status at baseline. Immediately post-intervention, children reported lower parenting and family unity scores compared with those in the usual-care group. These changes resolved at 3-month follow-up. Qualitative reports from clinical counselor intervention sessions described supported parenting during disclosure. Overall findings suggest adjustments in parenting, family unity, and trust surrounding the disclosure process.
  
  
  CONCLUSIONS
  Family-based intervention may support parenting and promote child mental health during adjustment to caregiver HIV status disclosure. Further investigation is required to examine the role of family-based intervention in supporting parenting and promoting child mental health in HIV status disclosure.
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA , USA.
authors.forename: Sumona
authors.initials: S
authors.lastname: Chaudhury
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health , Boston, MA , USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Kirk
authors.affiliation: WE-ACTx for Hope , Kigali , Rwanda.
authors.forename: Charles
authors.initials: C
authors.lastname: Ingabire
authors.affiliation: FXB-Rwanda , Kigali , Rwanda.
authors.forename: Sylvere
authors.initials: S
authors.lastname: Mukunzi
authors.affiliation: Inshuti Mu Buzima, Partners in Health (PIH) , Kigali , Rwanda.
authors.forename: Beatha
authors.initials: B
authors.lastname: Nyirandagijimana
authors.affiliation: FXB-Rwanda , Kigali , Rwanda.
authors.forename: Kalisa
authors.initials: K
authors.lastname: Godfrey
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health , Boston, MA , USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Brennan
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health , Boston, MA , USA.
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
keywords: Rwanda; children affected by HIV AIDS; family-based intervention; parenting; resilience