Disclosure to school-age children infected with HIV: Effects of acculturation, health attitudes and beliefs, coping styles, and social support in caregiver decision making

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

F. Daniel Armstrong - Committee Chair

Second Committee Member

Peter Mundy - Committee Member


The present study investigated factors affecting caregivers' decision to disclose to their child about their child's HIV status. Caregivers face a number of difficult decisions with respect to their child's HIV diagnosis, one of which is whether and when to tell the child. Some research suggests there are positive outcomes associated with disclosure of diagnosis to pediatric populations because it helps children cope with their illness (Slavin, O'Malley, Koocher, & Foster, 1982; Clafin & Barbarin, 1991). Despite the positive effects of disclosure demonstrated in other pediatric illnesses (e.g., pediatric oncology), including reduction of anxiety, improved family functioning, and psychosocial adjustment, issues unique to HIV infection often lead to reluctance in caregivers of children with HIV to disclose their child's own HIV diagnosis to the child. For example, caregivers may fear that their child will tell others and, in turn, be ostracized, isolated, and rejected by those they have told. To date, no research is available regarding caregivers' health attitudes and beliefs, including perceptions about health, healthcare, causes of HIV, and thoughts about others' beliefs about HIV. Additionally, the role of acculturation of minority families with HIV in disclosure is unclear. Further, how social support and coping styles may be associated with caregivers' decision to disclose children's own HIV positive status to them is not well understood. This study was designed to investigate these specific factors as they are related to caregivers' disclosure to their child about their child's own HIV positive status. Caregiver acculturation, health beliefs, attitudes toward healthcare, coping style, and social support were assessed in a sample of 89 caregivers of children with HIV. Caregivers were racially and ethnically diverse, but predominantly African American, Haitian, or Hispanic. Ages ranged from 21 to 70+ years with 41--50 years as the median. Logistic regression analyses indicated that components of coping style and health beliefs were predictors of disclosure; whereas acculturation, attitudes toward healthcare, and social support were not. Findings have implications for health care providers in providing treatment to families dealing with this disease.


Psychology, Clinical

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