Breaking down the wall of silence around children affected by AIDS in Thailand to support their psychosocial health

• Published in: AIDS care 2010-03, Vol.22 (3), p.308-313
• Main Authors: Ishikawa, Naoko, Pridmore, Pat, Carr-Hill, Roy, Chaimuangdee, Kreangkrai
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - psychology; Adaptation, Psychological; Adolescent; Adult; AIDS; AIDS/HIV; Bereavement; Biological and medical sciences; Caregivers - psychology; Child; Child of Impaired Parents - psychology; Child welfare; Child Welfare - psychology; Children; Childrens health; Communication Barriers; Female; HIV; HIV and AIDS; HIV Infections - epidemiology; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Mental health; Middle Aged; Parents; Parents - psychology; Pregnancy; Psychological aspects; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychosocial factors; psychosocial health; Qualitative research; silence; Social interaction; Social psychiatry. Ethnopsychiatry; Sociocultural environment; Stereotyping; Stigma; Stress, Psychological; Students - psychology; Teachers; Thailand; Thailand - epidemiology; Truth Disclosure; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Walls
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540120903193732

This study examines the psychosocial needs of the children affected by AIDS. Eight primary school children aged 10-13 years who lost parents to AIDS or whose parents were living with HIV were closely followed for a period of one year and qualitative data on the psychosocial challenges they faced were collected using semi-structured interviews, observation, drawings and diaries. Data were also collected from their caregivers and classroom teachers using semi-structured interviews, as well as data from their classmates using a self-completion questionnaire. The findings strongly suggested that adults were creating a "wall of silence" around children affected by AIDS by hiding the parents' HIV status from them and avoid talking to them about HIV and AIDS. The silence was intended to protect the children from sadness, embarrassment, bullying and discrimination. In reality, however, the silence was found to have isolated them and increased their psychosocial vulnerability by blocking open communication with family members, peers and teachers, and left them to cope with their problems on their own. It is argued that to support the psychosocial health of these children, it is necessary for the adults to recognise the negative impact of silence and for the families and the school to be involved in a process of participatory learning and action to find culturally appropriate ways to break down the wall of silence, and promote more open communication.