Introduction
With the increased availability of the life-saving ARVs in most Sub-Saharan Africa
more HIV-infected children are surviving into their adolescent years and beyond
hence giving rise to the question of whether the caregiver should disclose or not
disclose the child’s HIV diagnosis to child. Little is known of the reasons and
experiences that motive or hinder caregivers from disclosing the HIV diagnosis to
the child.
Study Aim and objectives
This was aimed at identifying caregivers’ reasons for HIV diagnosis disclosure and
non-disclosure to HIV-infected children under their care. The study also explores
their experience with process of HIV diagnosis disclosure and non-disclosure to the
child.
Study methodology
Using qualitative descriptive research approach, twenty (20) caregivers of HIVinfected
children aged between 6 – 16 years receiving ART at Thamaga Primary
Hospital IDCC with unknown HIV diagnosis disclosure status were subjected to
audio-taped in-depth interviews for data capturing. Thematic content analysis was
used for data analysis using Nvivo8 software and 16 themes with their sub categories
were identified.
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Findings
Both caregivers of disclosed and non-disclosed HIV-infected children perceived
disclosure as a good thing to do with majority of the caregivers (60%) having
disclosed. Reasons for telling the children their HIV diagnosis were that the child
had the right to know his/her status; caregiver tired of keeping child HIV diagnosis a
secret; the caregiver’s believe that disclosure will improve the child’s ART adherence
and finally some caregivers felt the child had reached the right age or maturity for
disclosure. Non-disclosing caregivers felt that health care workers should assist
them in doing disclosure and identified the reasons for non-disclosure as the child
being too young and not asking questions about their illness; fear that disclosure
might hurt the child psychologically; fear that the child might not keep their HIV
diagnosis a secret leading to discrimination in the community while some caregivers
lack of knowledge on how to disclose. Non-disclosing caregivers managed
disclosure by not telling the child the truth about their diagnosis and using threats to
coerce them to take their ARV drugs.
Conclusions and recommendations
The decision to disclosure or not to disclose the HIV diagnosis to a child by a
caregiver is influenced by a number of reasons and their experiences. Caregivers of
HIV-infected children need to be assisted by a health care provider when disclosing
to the child and further assessment should be made in making disclosure part of the
holistic management of an HIV-infected child.