Background: The repercussions of being HIV positive coupled by the complications of
antiretroviral therapy are likely to cause distress, emotional and psychological problems
particularly among children infected by the virus. The limited support services for
children experiencing distress intensify the urgency to address this challenge. Despite the
availability of social workers and nurses‟ interventions currently in place, the number of
children in need of psychological care continues to increase. This is particularly true at
Deborah Retief Memorial (DRM) hospital, one of the main antiretroviral therapy
facilities in Kgatleng district, Botswana.
Method: The purpose of this study was to explore and describe the perceptions of social
workers, nurses and caregivers on key factors contributing to psychological distress of
HIV positive children. A descriptive, exploratory qualitative study design that employed
the use of in-depth interviews was used to conduct this study. Participants included four
caregivers of HIV positive children who seek antiretroviral therapy at DRM hospital
Infectious Diseases Control Clinic, together with five nurses and two social workers who
worked in the same clinic. Conventional content analysis was used to analyse the indepth
interview transcripts.
Results: Perceived psychological stressors for HIV positive children included disclosure
of HIV status, orphanhood, social problems, lifelong treatment, stigma, poor caregiverchild
relationship and lack of caregiver‟s love, care and support. However the caregivers
did not fully understand the psychological distress the HIV positive children were
experiencing, hence were unable to recognize it in these children. The study highlighted
that major challenges faced by the health-workers included lack of qualified personnel,
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lack of adequate knowledge and skills, and a non-conducive working environment
required to effectively assist children with psychological distress. The findings also
indicated the need for education and support of caregivers and HIV positive children by
the educators, family and health-worker systems.
Conclusion: The profile of key stressors of psychological distress, the challenges and
support needs suggested by the participants in this study can provide a framework for
improving the existing services for HIV positive children with psychosocial problems.
This information is important for use in training nurses and social workers involved with
children with psychological behaviours