HIV serostatus disclosure from mothers to children: Influencing factors

Abstract

AIDS is currently the third leading cause of death for women ages 25-44 in the United States. In 1996, women accounted for 20% of all newly reported AIDS cases. Since 1981, a total of 573,800 adolescents and adults with AIDS were reported to the Centers For Disease Control and Prevention.;The impact of the AIDS pandemic raises particular social concern because of the volume of children orphaned by maternal deaths since 1981. Recent estimates project that by the year 2000, as many as 325,000 children and adolescents will become orphaned as a result of AIDS-related illness.;This investigation describes the impact of perceived stigma on the disclosure process from HIV seropositive mothers to their children, identifies key biopsychosocial characteristics which may play a role in disclosure, and reports anecdotal experiences with disclosure.;Eighty-eight (88) HIV seropositive adult women with children enrolled in outpatient care at Beth Israel Medical Center participated in this descriptive and explanatory study.;The study found that HIV seropositive women reported high perceived stigma, devaluation-discrimination, estrangement, and used secrecy as a stigma management tool. High stigma was significantly correlated with low disclosure to children.;The study group scored significantly higher than an outpatient psychiatric female norm on the Profile of Mood States (POMS) for five of six mood factors. Among the study group, Confusion-Bewilderment and Anger-Hostility were significantly correlated with low disclosure to children.;Logistic regression analysis revealed that social support and length of time since diagnosis were positively correlated and education was negatively correlated with disclosure to children.;The key findings in this study provide critical information which can be utilized by social workers and other health care professionals working with HIV seropositive women faced with disclosure of their serostatus to their children.