Abstract

BackgroundDisclosure of human immunodeficiency virus (HIV) status may be perceived as simply the process of revealing a person’s HIV status, whether positive or negative. Despite the emerging evidence of the benefits of disclosure, who, when and what to disclose to a HIV-infected child remains a challenge.AimThis article reports on the patterns of HIV status disclosure to the infected children by their parents and caregivers.SettingThe study was conducted in the outpatient clinic of one referral hospital offering comprehensive HIV care in the Lubombo region, eSwatini.MethodsA qualitative descriptive design was followed. Data were collected through semi-structured individual interviews with a purposive sample of 13 parents and caregivers whose children were on antiretroviral treatment and collecting treatment from the specific outpatient clinic. Audio recorded data were transcribed verbatim, thematic content analysis was done and used to organise and present the findings.ResultsFour themes that emerged in relation to the topic of patterns of disclosure were disclosure of HIV status as a process rather than an event, a proposed person to disclose the HIV status to the child, the appropriate age to disclose HIV status to a child and type and amount of information to give in relation to the HIV status. The proposed person to disclose the HIV status to the infected child was the parent or caregiver involved as the primary carer of the child. There was no agreeable appropriate age to disclose HIV status to an infected child and the type and amount of information to disclose varied with the individuals depending on what prompted disclosure.ConclusionHuman immunodeficiency virus disclosure to children demands parents’ and caregivers’ participation and their knowledge of child development.

Highlights

  • Human immunodeficiency virus (HIV) affects both adults and children because of its mode of transmission as in mother-to-child transmission of HIV

  • Antiretroviral therapy has been free in eSwatini since 2003.4 In 2014, eSwatini adopted the 2013 World Health Organization (WHO) guidelines of which one is that anyone diagnosed with HIV should be started on antiretroviral therapy (ART) regardless of their CD4 count

  • The participants were 2 males and 11 females, aged 26–70 years and related to the children infected with HIV as parents or caregivers

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Summary

Introduction

Human immunodeficiency virus (HIV) affects both adults and children because of its mode of transmission as in mother-to-child transmission of HIV. The use of antiretroviral therapy (ART) has become widely used for HIV and is available in developing countries including eSwatini This increases the number of HIV-infected children surviving into adolescence and beyond. In eSwatini, 13 000 children aged 0–14 years were living with HIV in 2017 of whom 75% were on antiretroviral treatment.[1,2,3] Antiretroviral therapy has been free in eSwatini since 2003.4 In 2014, eSwatini adopted the 2013 World Health Organization (WHO) guidelines of which one is that anyone diagnosed with HIV should be started on ART regardless of their CD4 count. Despite the emerging evidence of the benefits of disclosure, who, when and what to disclose to a HIVinfected child remains a challenge

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