Armistead L, Tannenbaum L, Forehand R, Morse E, Morse P
Department of Psychology, Georgia State University. Atlanta, Georgia 30303, USA.
J Pediatr Psychol. 2001 Jan-Feb;26(1):11-20. doi: 10.1093/jpepsy/26.1.11.
Mothers living with HIV face a complex set of child-rearing decisions, often within the context of many competing stressors. One difficult decision for HIV-infected mothers is whether to disclose their HIV status to their children. The purpose of this study is to provide information to HIV-affected families and the professionals working with them as they approach disclosure-related decisions.
Eighty-seven HIV-infected African American mothers and one of their children who was not HIV-infected were separately interviewed on two occasions. Mothers reported whether they disclosed their HIV status to the child and provided their assessment of the child's functioning. Children also completed an assessment of their functioning.
Results revealed that less than one-third of mothers disclosed their HIV status to their children. Disclosure was associated with mother's income level and perceived severity of physical symptoms. In addition, children disclosed to were more often older and female. Contrary to expectation, disclosure was not related to child functioning.
Professionals should note the low rate of disclosure among these families. In the absence of conclusive data regarding impact on child functioning, professionals must remain aware of the complexity of disclosure-related decisions when working with HIV-affected families, particularly in terms of the family and cultural milieu within which families operate.
感染艾滋病毒的母亲面临一系列复杂的育儿决策，这些决策往往处于诸多相互竞争的压力源的背景之下。对于感染艾滋病毒的母亲而言，一个艰难的决定是是否向子女披露自己的艾滋病毒感染状况。本研究的目的是在受艾滋病毒影响的家庭及其相关专业人员面临与披露相关的决策时，为他们提供信息。
对87名感染艾滋病毒的非裔美国母亲及其一名未感染艾滋病毒的子女分别进行了两次访谈。母亲们报告了自己是否向孩子披露了艾滋病毒感染状况，并给出了对孩子机能状况的评估。孩子们也完成了对自身机能状况的评估。
结果显示，不到三分之一的母亲向孩子披露了自己的艾滋病毒感染状况。披露情况与母亲的收入水平以及身体症状的感知严重程度有关。此外，被告知的孩子往往年龄较大且为女性。与预期相反，披露情况与孩子的机能状况无关。
专业人员应注意到这些家庭中披露率较低的情况。在缺乏关于对孩子机能状况影响的确凿数据的情况下，专业人员在与受艾滋病毒影响的家庭合作时，必须意识到与披露相关的决策的复杂性，尤其是在家庭运作所处的家庭和文化环境方面。
