# Efficacy of a cluster randomized controlled parental HIV disclosure intervention trial among parents living with HIV in China: evaluation based on the health action process approach

## TL;DR

A study in China evaluated an HIV disclosure intervention for parents, finding it helped move them from planning to taking action, but not in earlier stages.

## Contribution

The study introduces a stage-specific intervention framework for HIV disclosure based on the Health Action Process Approach.

## Key findings

- The intervention significantly increased progression from pre-intention to action (OR = 3.43).
- No significant effect was observed on transitions from pre-intention to intention.
- Stage-specific interventions are needed to improve HIV disclosure practices.

## Abstract

Parents living with HIV (PLH) face psychosocial challenges, including disclosing their HIV status to their children. Parental HIV disclosure is critical for reducing stigma, improving psychosocial well-being, and enhancing family cohesion. This study employed the Health Action Process Approach (HAPA) to assess the efficacy of a theory-based intervention aimed at facilitating HIV disclosure among PLH with children aged 6-15 in Guangxi, China.

Data from a randomized controlled trial involving 791 PLH were analyzed using a multigroup first-order manifest Markov Chain model to investigate transitions through the pre-intention, intention, and action stages over two follow-up periods (6 and 12 months).

The intervention significantly facilitated progression from pre-intention to action (OR = 3.43; 95% CI: 1.17, 10.01) but did not affect the transition from pre-intention to intention (OR = 1.02; 95% CI: 0.47, 2.20) or influence movement within the intention stage.

These findings suggest the need for stage-specific interventions to enhance disclosure practices. Future research should focus on identifying psychosocial predictors of disclosure and adapt interventions to the distinct stages of the disclosure decision-making process.