The Amagugu intervention: a conceptual framework for increasing HIV disclosure and parent-led communication about health among HIV-Infected parents with HIV-uninfected primary school-aged children

Rochat, T. J., Mitchell, J., Stein, A., Mkwanazi, N. B. and Bland, R. M. (2016) The Amagugu intervention: a conceptual framework for increasing HIV disclosure and parent-led communication about health among HIV-Infected parents with HIV-uninfected primary school-aged children. Frontiers in Public Health, 4, 183. (doi:10.3389/fpubh.2016.00183) (PMID:27630981) (PMCID:PMC5005419)

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Abstract

Advances in access to HIV prevention and treatment have reduced vertical transmission of HIV, with most children born to HIV-infected parents being HIV-uninfected themselves. A major challenge that HIV-infected parents face is disclosure of their HIV status to their predominantly HIV-uninfected children. Their children enter middle childhood and early adolescence facing many challenges associated with parental illness and hospitalization, often exacerbated by stigma and a lack of access to health education and support. Increasingly, evidence suggests that primary school-aged children have the developmental capacity to grasp concepts of health and illness, including HIV, and that in the absence of parent-led communication and education about these issues, HIV-exposed children may be at increased risk of psychological and social problems. The Amagugu intervention is a six-session home-based intervention, delivered by lay counselors, which aims to increase parenting capacity to disclose their HIV status and offer health education to their primary school-aged children. The intervention includes information and activities on disclosure, health care engagement, and custody planning. An uncontrolled pre–post-evaluation study with 281 families showed that the intervention was feasible, acceptable, and effective in increasing maternal disclosure. The aim of this paper is to describe the conceptual model of the Amagugu intervention, as developed post-evaluation, showing the proposed pathways of risk that Amagugu aims to disrupt through its intervention targets, mechanisms, and activities; and to present a summary of results from the large-scale evaluation study of Amagugu to demonstrate the acceptability and feasibility of the intervention model. This relatively low-intensity home-based intervention led to: increased HIV disclosure to children, improvements in mental health for mother and child, and improved health care engagement and custody planning for the child. The intervention model demonstrates the potential for disclosure interventions to include pre-adolescent HIV education and prevention for primary school-aged children.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Bland, Dr Ruth
Authors: Rochat, T. J., Mitchell, J., Stein, A., Mkwanazi, N. B., and Bland, R. M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Frontiers in Public Health
Publisher:Frontiers Media
ISSN:2296-2565
ISSN (Online):2296-2565
Published Online:31 August 2016
Copyright Holders:Copyright © 2016 Rochat, Mitchell, Stein, Mkwanazi and Bland
First Published:First published in Frontiers in Public Health 4:183
Publisher Policy:Reproduced under a Creative Commons License

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