The south american context of diagnostic disclosure of adolescents infected by HIV/AIDS: a systematic literature review

Pinheiro, Patrícia Neyva da Costa; Kendall, Bernard Carl; Kerr, Ligia Regina Franco Sansigolo; Pickett, Keith Michael; Luna, Izaildo Tavares; Costa, Maria Isabelly Fernandes da; Luz, Luisa Fânia da Costa

doi:10.1590/1806-9282.66.8.1139

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Revista da Associação Médica Brasileira

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REVIEW ARTICLE • Rev. Assoc. Med. Bras. 66 (8) • Aug 2020 • https://doi.org/10.1590/1806-9282.66.8.1139 copy

The south american context of diagnostic disclosure of adolescents infected by HIV/AIDS: a systematic literature review

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE

To analyze the scientific evidence on the disclosure of the diagnostic of adolescents infected by HIV/AIDS in the South American context.

DATABASE

Systematic literature review using the PubMed, Cinahal, Embase, Cochrane, BVS, and Global Health databases and the descriptors: adolescent and HIV and family and Argentina or Bolivia or Brasil or Chile or Colombia or Ecuador or French Guiana or Paraguay or Peru or Uruguay or Venezuela.

DATA SYNTHESIS

Brasil was the country highlighted. It was verified that parents have a direct and indirect influence over the adolescents’ life, especially regarding behaviors and health care. Dialog among family members can reduce adolescents’ vulnerability to HIV and encourage diagnostic disclosure.

CONCLUSION

It is necessary to amplify research involving adolescents with HIV/AIDS and their parents/caregivers and family members to improve care and reduce the cases of the disease. It is suggested that policies of prevention and treatment should involve families, caregivers, partners, and the community.

Family; Adolescent; HIV; South America

Code	Author, Year, Place	Title/ Journal	Design/Sample/Problem
1	Marques et al. , 2006; São Paulo and Santos	Disclosure of HIV infection from the perspective of adolescents living with HIV/aids and their parents and caregivers- Cad. Saúde Pública	- Qualitative; Study; 22 adolescents and 13 cares - HIV Seropositivity
2	Peres et al. , 2008; São Paulo	Family Structure and Adolescent Sexual Behavior in a Poor Area of São Paulo, Brazil- Journal of Adolescet Health	- Cross-sectional study; 296 young people/adolescents- Vulnerability to HIV
3	Lima & Pedro, 2008; Porto Alegre, RS	Growing up with HIV/aids: a study on adolescents with HIV/aids and their family caregivers- Rev Latino-am Enfermagem	Exploratory study with a qualitative approach - Growth and development with HIV
4	Barbosa et al. , 2008; Fortaleza	Stages of change in parents discussions with their children about HIV/aids prevention- Revista Latino America de Enfermagem	- HIV Prevention
5	Galano et al. , 2012; São Paulo	Interviews with family members: the essential tool for planning the disclosure of the diagnosis of HIV/aids for children and adolescents- Ciência & Saúde Coletiva	Qualitative study; 23 parents/relatives- HIV Seropositivity
6	Cammarano Ribeiro et al. , 2013; Rio Grande do Sul	Therapeutic everyday of adolescent who has HIV/aids: self-caring occupation and family solitude- Ciência, Cuidado & Saúde	Qualitative study with phenomenological approach and philosophical theoretical methodological; 16 adolescents- Growth and development with HIV

Intervention	Code/Comparison	Result/Evidence
1	Disclosure of the diagnosis/ Enhancing Care Initiative (ECI)	The disclosure of the diagnosis is a milestone in the life of the adolescents and families. The fear of prejudice, discrimination, and social isolation are complicating factors in the disclosure of the diagnosis. On the other hand, the need for adherence to treatment and questions are facilitators. Adolescents who became infected by vertical transmission have different care in comparison to others. The demand is created by the family and health team.
2	Influence of parents on the behavior of children/ Studies from Latin America, Caribbean and United States	Adolescents living with parents are less exposed to risks. The influence of one or both parents in the life of adolescents contributes to reducing the risks to which they are exposed. Efforts focused on the reduction of risks in adolescence should involve the parents.
3	Treatment, disclosure of the diagnosis, influence of parents and teachers;	Changes in the quality of life of adolescents and their relatives. Changes in lifestyle due to the treatment and care. Confidentiality regarding the disclosure of the diagnosis to society for fear of prejudice, discrimination, and social isolation. No approach from the family, school and health services regarding bodily changes , sexual and reproductive health of these adolescents. Strong influence of the media.
4	Dialog	Adolescents are vulnerable to risks because parents find it difficult to talk with their children about sex/sexuality. Mothers are more present than fathers in the education of their children. Low parental schooling hinders dialog. The inability of parents to establish dialog increases adolescents' vulnerability to HIV/aids. Efforts focused on the prevention of HIV should involve adolescents, families, schools, and health units.
5	Disclosure of the diagnosis; Handbook prepared by members of the Institute of Health of New York	The decision to disclose the diagnosis is a slow and painful process Fear of prejudice, discrimination, and social isolation, guilt, changes in mental health, and desire to live are complicating factors in the disclosure of diagnosis. On the other hand, the need for adherence to treatment, the ability to keep a secret, and questions are facilitators.
6	Treatment	Changes in the quality of life of adolescents. Changes in lifestyle due to the treatment and care. Need for strengthening of self-care strategies. Family was the main support source.

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[1] CORRESPONDING AUTHOR: Patrícia Neyva da Costa Pinheiro Rua Alexandre Baraúna, 1115, Rodolfo Teófilo, CE , Brasil – 60430-160 Tel: +55 85 3366-8455 / Fax: +55 85 3366-8456 E-mail: neyva.pinheiro@yahoo.com.br