Silence et divulgation dans des familles d'adolescents vivant avec le VIH depuis la naissance : une exploration qualitative

Objective Studies targeting children born with HIV have principally focused on the period preceding the announcement of the diagnosis to the child. The objective of the present study was to explore intrafamilial communication dynamics following the announcement of the diagnosis. Methodology Twenty-nine youths (10 to 18 years of age) living with HIV since birth participated in individual semistructured interviews about the following: 1) serostatus disclosure, 2) family relations and 3) sexual education within the family. The testimonials underwent a content analysis. Results The youths learned of their HIV-positive diagnosis at the average age of 11 years. The dynamic established after the announcement appears to be regulated by silence: the exchanges that follow mainly involve questions related to medication and prevention of sexual transmission of the virus. This silence preserves the familial equilibrium by performing three functions: protecting the mother from a feeling of guilt regarding transmission, assuring family harmony and feeling normal compared with others. The adolescent's diagnosis is generally not revealed to the extended family, thus preserving their integration within the family by protecting them from rejection, betrayal and judgement. Discussion The functions of silence and the secret serve as important stabilizers within the family. However, they contribute to the isolation of the adolescents in the form of emotional support that they still need. Suggestions for intervention are presented.