Caregivers' perceptions towards disclosure of Human Immunodeficiency Virus positive status to children living with HIV at Mohodi Community in the Limpopo Province

Abstract

Background: the purpose of this study was to explore the caregiver’s perceptions towards disclosure of human immunodeficiency virus positive status to children living with HIV at Mohodi community in the Limpopo province. Many children who are HIV positive grow up unaware of their HIV positive status, because caregivers are afraid or uncomfortable to inform their children about their positive HIV status. Evidence from some studies have identified non-disclosure of HIV positive status to children as one of the actors that lead to a delay in access to treatment. Therefore the study seek to explore caregivers’ perceptions towards disclosure of HIV positive status to children living with HIV at Mohodi community in the Limpopo Province. The objectives of the current study were to discover the insights of caregivers towards disclosing the HIV positive status to their children living with HIV and to determine contributory factors to the delayed disclosure of HIV positive status to children living with HIV amongst caregivers at Mohodi community in the Limpopo Province. Methods: The study used the qualitative research design. A qualitative exploratory descriptive design was used to reflect the naturistic perspective and to understand a phenomenon in a natural setting. Participants of the study were caregivers taking care of children who are living with HIV. The children who are unaware of their HIV status. Data was collected through in-depth interview with open ended questions, participants were interviewed one by one using an interview guide. The sample size was 10 participants which was determined by saturation of data. An audiotape was also used to record interviews with participants, and field notes were also taken during the interview. Data was analysed through Thematic Content Analysis. Results: HIV disclosure to children is generally low, even among adolescents. Significant factors influencing disclosure include the child's age, the child's persistent questioning and caregivers’ perceptions of the child's ability to understand and cope up with HIV. The literature suggest that caregivers identify many barriers to disclosure within these settings, the most prominent being fear of stigma and of negative consequences for children's emotional and social well-being. In the midst of caregivers’ worries about disclosure and low prevalence of disclosure, there is only limited evidence to suggest how disclosure should be conducted. The study provide useful qualitative enquiry of how the caregivers at Mohodi village perceive the disclosure of HIV towards their children living with HIV. Conclusions: The study revealed that the reasons for non-disclosure from caregivers is that they believe that the child is either not old enough or not ready to comprehend the meaning of their HIV positive status. Some are of the view that the children are not sufficiently mature to cope with their HIV positive status. Some believe that, their children would not keep their diagnosis private and therefore concerned that their children would be exposed to stigmatisation and discrimination in their communities and families. These concerns suggest that improved psychosocial support services could aid in the disclosure process, Social workers and health care professionals to work hand in hand to enhance referrals. There is a need for structured, evidence-based protocols, materials and guidelines for disclosure which will equip the caregivers with knowledge about HIV disclosure to their children living with HIV.