Does Maternal HIV Disclosure Self-Efficacy Enhance Parent–Child Relationships and Child Adjustment?


Nondisclosure of maternal HIV status to young children can negatively impact child functioning; however, many mothers do not disclose due to lack of self-efficacy for the disclosure process. This study examines demographic variations in disclosure self-efficacy, regardless of intention to disclose, and assesses the relationship between self-efficacy and child adjustment via the parent–child relationship among a sample of HIV+ mothers and their healthy children (N = 181 pairs). Mothers completed demographic and self-efficacy measures; children completed measures assessing the parent–child relationship and child adjustment (i.e., worry, self-concept, depression). Across demographics, few mothers reported confidence in disclosure. Results from covariance structural modeling showed mothers endorsing higher self-efficacy had children who reported better relationship quality, and, in turn, reported fewer adjustment difficulties; higher levels of disclosure self-efficacy also directly predicted fewer adjustment problems. Findings offer support for interventions aimed at providing mothers with skills to enhance confidence for disclosing their HIV status.


Al no revelar el estado de VIH materno a los niños pequeños puede tener un impacto negativo en el funcionamiento del niño; sin embargo, muchas madres no revelan su estado debido a la falta de autoeficacia en el proceso de revelación. Este estudio examina las variaciones demográficas en la autoeficacia de revelación, independientemente de la intención de revelar, y evalúa la relación entre autoeficacia y ajuste infantil a través de la relación entre padres e hijos entre una muestra de madres VIH + y sus hijos sanos (N = 181 pares). Las madres completaron medidas demográficas y de autoeficacia; los niños completaron medidas para evaluar la relación entre padres e hijos y el ajuste del niño (por ejemplo, preocupación, autoconcepto, depresión). A través de la demografía, pocas madres reportaron tener confianza en revelar su estado de VIH. Los resultados de la modelación estructural de covarianza mostraron que las madres que respaldan una mayor autoeficacia tenían hijos que reportaron una mejor calidad de relación y, a su vez, informaron menos dificultades de adaptación. Niveles más altos de autoeficacia de revelación también predijeron directamente menos problemas de ajuste. Los hallazgos ofrecen apoyo para las intervenciones dirigidas a proveer madres con las habilidades para aumentar la confianza a la hora de revelar su estado de VIH.

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This study was funded by the National Institute of Mental Health (Grants R01MH094233-Armistead & R01MH09418 -Schulte). The authors wish to thank the families who participated in this research, as well as Ivette Avina and Rosa Felix for their contributions to quality assurance and translation of the abstract.

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Correspondence to Lisa Armistead.

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The authors have no conflicts of interest relevant to this article to disclose.

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The authors declare they have no conflicts of interest. All procedures performed in this study were in accordance with the ethical standards of the universities’ institutional review boards and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all adult participants included in the study. Parental consent and child assent were obtained from participants under age 18.

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Armistead, L., Goodrum, N., Schulte, M. et al. Does Maternal HIV Disclosure Self-Efficacy Enhance Parent–Child Relationships and Child Adjustment?. AIDS Behav 22, 3807–3814 (2018).

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  • HIV disclosure
  • Parent–child relationship
  • Disclosure self-efficacy