Factors affecting parental disclosure of HIV status to HIV-Positive children and adolescents

Abstract

Disclosing the diagnosis of HIV or AIDS to a child is a controversial and emotionally-charged issue among health workers, parents and caregivers of these children.195 parents and guardians were enlisted for this cross-sectional and exploratory study. A survey questionnaire and one to one in-depth interviews were used to collect the data. Data was analysed using SPSS version 17 and modified grounded theory.We found that HIV status disclosure was very low and stood at 32.3%. The pattern of disclosure was such that n= 32 (51%) opted for full disclosure whereas n= 31 (49%) opted for partial disclosure. The proportions opting for full disclosure of the child’s HIV status were higher in the age groups of children 6 to 10 and over 10 years (that is when the child was older than five years) and age was statistically significant for those less than five years children (p = 0.000). The proportions for full disclosure were not high among parents or guardians who had biological or other children and this did not reach the significance level (p = 0.489). The level of education had no clear association with parent’s desire to disclose the child’s status (p = 0.544). Risks of disclosure outweighed benefits of disclosure as factors for disclosure. The quality of counselling was good. The following is recommend:There is need for parents or guardians of HIV-infected children and adolescents to be counselled before HIV status disclosure is done to the child/adolescent and to be provided with ongoing help and support during and after the difficult and distressing task of disclosing the diagnosis to these children. (1)Parental and child factors both need to be considered regarding disclosure of HIV status to the child. (2)Parents or guardians of HIV-infected children and adolescents need to be empowered to believe they have the best knowledge of themselves and their family and will know the best time to disclose to their children.(3)While current knowledge is insufficient for determining whether the choice and time of HIV status disclosure to children should be based on age groups or developmental milestones, increased attention to training in counselling and development of simplified tools for developmental assessments by primary health care workers is necessary.