Caregivers’ attitudes towards HIV testing and disclosure of HIV status to at-risk children in rural Uganda
Date
2016-03-22
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
Type
Thesis
Degree Level
Masters
Abstract
Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For nearly all (96%) respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Major themes identified included caregivers stressing medication adherence when informing the child of their positive status and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65%) children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7 (±2) years. Caregivers reported that children began to learn about HIV at the same age they were informed of their positive status, and as many as two thirds (64%) of the caregivers sought advice from an HIV counsellor prior to disclosure. 45% of caregivers admitted to initially telling the child that they had a disease other than HIV, and this period of deceiving the child had a mean length of 3 (±2) years. 79% of caregivers reported that a child would be discriminated against in their community if the community learned of their HIV status, and 64% agreed that a child would feel that their life was without hope if they became aware of their HIV status. These findings suggest that while the age of HIV status disclosure in this setting is similar to what is recommended by current guidelines, the HIV disclosure experience in Mbarara and Isingiro districts differs with respect how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child’s level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained to facilitate the disclosure process as important avenues for further research.
Description
Keywords
Pediatrics, HIV Status Disclosure, HIV Testing, Uganda
Citation
Degree
Master of Science (M.Sc.)
Department
Pharmacy and Nutrition
Program
Pharmacy