RESUMO
Background & objectives: Karnataka is a high HIV prevalent State in India. Although benefits have been shown by disclosing the HIV status to the child, information regarding HIV status disclosure in Karnataka is limited. Hence, this study was conducted to estimate the proportion of children who had been disclosed of their HIV status and its pattern among those who visited the district antiretroviral therapy (ART) centre in coastal Karnataka. Methods: A cross-sectional study was conducted in an ART centre in a district hospital in coastal Karnataka between October 2014 and July 2015. Caregivers of paediatric HIV patients were approached and willing participants were administered a pre-formed, pre-tested semi-structured questionnaire developed for the study. Results: A total of 185 caregivers of the HIV-positive children were interviewed. Mean age of the children was 11�years. Only 107 (57.8%) children were aware of their HIV status. Of these, 95 were disclosed fully. Counsellors in rehabilitation centres were the most probable person to disclose and planned events. Children were told of their HIV status for their knowledge and were more likely to be disclosed if they were around 11-15 yr of age and staying in rehabilitation centres. Interpretation & conclusions: Older children were more likely to be disclosed of their HIV status by counsellors. Steps need to be taken to counsel and encourage caregivers to fully disclose the HIV status to the children at least when they attain the age more than 11 years.
RESUMO
Este trabalho objetiva pesquisar a potencialidade mutativa do uso de histórias ficcionais personalizadas para revelar diagnóstico de doença orgânica para crianças e adolescentes. Articula-se ao redor de sessões de atendimento psicológico de uma adolescente HIV+, registradas sob a forma de narrativas transferenciais e apreciadas à luz do Procedimento de Ambrosio e Vaisberg de avaliação de benefícios psicoterapêuticos. Por essa via, foi possível constatar que o uso da história favoreceu uma experiência mutativa de transição desde um posicionamento defendido e dissociado para outro mais integrado e menos ansioso, caracterizado pela possibilidade de maior tolerância ao sofrimento quando o pertencimento à vida comum é oferecido. Interlocuções clínico-reflexivas com a psicanálise winnicottiana finalizam o texto, evidenciando a passagem do diagnóstico HIV+ de objeto subjetivo para objeto pertencente ao mundo compartilhado.
This work investigates the mutative potential of using personalized fictional stories to reveal to children and adolescents the diagnosis of organic diseases. It is set around psychology sessions of an HIV+ adolescent which were transcribed in the form of transference narratives and examined under the Ambrosio and Vaisberg Procedure for evaluation of psychotherapeutic benefits. Adopting this procedure, it was possible to verify that the use of stories favored a mutative experience of transition from a defended and dissociated position to a more integrated and less anxious position, characterized by the possibility of greater tolerance to suffering when the option of belonging to ordinary life is offered. Clinical and reflective dialogues with Winnicot psychoanalysis finalize the text, evidencing the passage of a HIV+ diagnosis from a subjective object to an object that belongs to the shared world.
Este trabajo busca investigar la potencialidad cambiante del uso de historias ficticias personalizadas para revelar el diagnóstico de enfermedad orgánica para niños y adolescentes. Está elaborado alrededor de sesiones de atención psicológica de una adolescente VIH+ que fueron registradas en forma de narraciones transferenciales y apreciadas a la luz del Procedimiento Ambrosio y Vaisberg de evaluación de beneficios psicoterapéuticos. Por esta vía, ha sido posible constatar que el uso de la historia favoreció una experiencia cambiante de transición desde una posición de defensa y disociada para otra más integrada y menos ansiosa, caracterizada por la posibilidad de mayor tolerancia al sufrimiento cuando el pertenecer a la vida en común es ofrecido. Interlocuciones clínico-reflectivas con el psicoanálisis winnicottiano finalizan el texto, evidenciando la transición del diagnóstico VIH+ de objeto subjetivo para objeto perteneciente al mundo compartido.