Table 2.

Impact of Intervention on Disclosure

Family types	Disclosure continuum plan		N
	Before first intervention session	After third intervention session
Harmonious family (Good family relationships)	Partial disclosure	Key disclosure	3
	Partial disclosure	Indirect disclosure	1
	Indirect disclosure	Key disclosure	3
Single-parent family	Vague disclosure	Key disclosure	1
	Partial disclosure	Key disclosure	1
Indifferent family (Disconnected family relationships)	Vague disclosure	Partial disclosure	1

Intervention contents:

First intervention. The study participant shared his/her experiences of when and how s/he knew about his/her HIV diagnosis and to whom s/he had disclosed. The nurse interventionist briefly discussed the target child's situation, including the child's age, developmental stage, and his/her personality. Then, the interventionist and the parent discussed the pros and cons of disclosure to the child. During this session, the interventionist provided psychoeducation to enhance parent-child communication and assigned use of appropriate communication strategies as homework.

Second intervention. The interventionist engaged the parent in a collaborative discussion about the potential reactions of their children during the disclosure process. The research team created a handout of developmentally appropriate and typical communication abilities and reactions of children ranging from 13-to-25 years of age for parents to feel more prepared about what to anticipate. Parents were asked to share how the child reacted in previous major events inside the family. In addition, the interventionist taught the parent about a disclosure continuum that ranged from no disclosure to complete and open disclosure with behaviorally specific descriptions of stages in between. For homework, the parent was asked to think about where s/he would like to be on the continuum in the near and later future.

Third intervention. In the last session, the interventionist assisted the parent to come up with a plan to achieve the desired stage on the continuum. Parents role-played the disclosure event with the interventionist, including answering potential questions from their children and anticipating possible reactions. The interventionist helped the parents troubleshoot potential barriers to taking steps toward where they wanted to be on the continuum, and on completion of the intervention parents were encouraged to enact the plan discussed.