title: Dealing with disclosure: Perspectives from HIV-positive children and their older carers living in rural south-western Uganda.
abstract: There are limited data on the challenges faced by carers, in particular older carers, in managing the difficult task of status disclosure for HIV-positive children. We report findings from qualitative interviews with 18 care dyads of older people and HIV-positive children living in rural south-western Uganda. Our data provide insights into perceptions and norms influencing communication during and following disclosure among both carers and children, including those shaped by gendered expectations of girls' and boys' sexual behaviour. Young participants reported several advantages of knowing their status and showed considerable resilience in the face of HIV disclosure. Better and more support is needed to help health workers and carers (particularly older carers) manage cross-generational communication around HIV disclosure and other related aspects of sexual and reproductive health as critical aspects of children's psychosocial development and well-being.
authors.affiliation: a Department of International Public Health , Liverpool School of Tropical Medicine , Pembroke Place, Liverpool , United Kingdom.
authors.forename: Esther
authors.initials: E
authors.lastname: Dusabe-Richards
authors.affiliation: b Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.
authors.forename: Rwamahe
authors.initials: R
authors.lastname: Rutakumwa
authors.affiliation: b Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.
authors.forename: Flavia
authors.initials: F
authors.lastname: Zalwango
authors.affiliation: b Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.
authors.forename: Allen
authors.initials: A
authors.lastname: Asiimwe
authors.affiliation: b Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.
authors.forename: Elvis
authors.initials: E
authors.lastname: Kintu
authors.affiliation: b Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.
authors.forename: Fatuma
authors.initials: F
authors.lastname: Ssembajja
authors.affiliation: b Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.|c Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D005260:Female; D006679:HIV Seropositivity / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012424:Rural Population; D014342:Truth Disclosure / Q000941:ethics*; D014454:Uganda
keywords: HIV disclosure; HIV-positive children; older carers; psychosocial well-being