Disclosure of Parents’ HIV Status to Children: A Model Derived from the Experiences of Families in Makete District, Tanzania

Abstract

The HIV/AIDS literature has indicated that parents' disclosure of their HIV status significantly affects children’s behaviour. However, in Tanzania, limited research exists regarding how and when parents should disclose their HIV status to children to minimise or avoid negative outcomes. This paper, based on research conducted in Makete District, explores parents’ disclosure of their HIV status to propose a model to guide the process. The study employed a qualitative ethnographic research design, using in-depth interviews, focus group discussions, observation, and documentary analysis as data collection methods.  Data were analysed using NVivo 8 qualitative analysis software after saturation was reached.  A total of 70 informants—including 33 parents, 20 children, ten family members, and seven healthcare professionals (4 healthcare workers and three community-based HIV service providers)—were included through purposive and snowball sampling. Informants were selected based on their experience with disclosure or their professional roles in providing HIV services. The sample was determined based on the criteria that parents who had disclosed their HIV status to their children, as well as the professionals who offered services to the parents. The findings suggest that a well-planned disclosure process enhances positive outcomes for children. Consequently, this paper proposes a four-stage model tailored to the Tanzanian context: preparation, the disclosure event, consolation, and the disclosure outcome. This model is intended for use by healthcare professionals to guide parents through a recommended approach for disclosing their HIV status to their children.