Integrated model of maternal caregiving in child HIV management in Chinese mother–child dyads living with HIV: A qualitative dyadic analysis

Abstract

Perinatally HIV-positive (PHIV+) children face challenges arising from their complicated and highly stigmatized chronic illness throughout childhood and adolescence. Caring and support from caregivers are vital, especially from their mothers who also live with HIV. However, little is known regarding how HIV+ mothers coach their PHIV+ children to adjust to HIV. This study used dyadic-level qualitative analyses of semi-structured, one-on-one interviews among 20 mother–child dyads (n = 40; children aged 12–18 years) living with HIV in southern China. Interviews examined the perspectives of both mothers and children on the maternal caregiving in child HIV management and child adaptation outcomes. Our findings showed that based on a dual-dimension model of the extent of maternal involvement in child HIV management and the intimacy of the mother–child relationship, four categories of maternal caring emerged among the mother–child dyads: supportiveness (n = 4, 20%), independence (n = 9, 45%), contradiction (n = 4, 20%) and alienation (n = 3, 15%). The PHIV+ children's selected HIV management indicators (including disclosure of HIV status, HIV-related communication, antiretroviral therapy adherence, stigma coping and emotion management) also showed some variations among these four categories. The integrated model may inform the development of dyadic intervention programmes tailored for mothers and children both living with HIV.