Factors that influence parents to disclose or not to disclose HIV status to their children who are living with HIV/AIDS in the greater Harare area in Zimbabwe
Thesis (MPhil) -- Stellenbosch University, 2012.
ENGLISH ABSTRACT: This study seeks to find factors that influence parents to disclose or withhold HIV status to the children who are living with HIV/AIDS. The observation from practice in the HIV clinics is that some children go to the age of up to 16 years without knowing their status. This is despite the fact that some of them will be taking medication which they are not told what it is for. Different parents give different explanations and most will always say they will disclose to their children when they feel that they are ready... Some cultural and religious beliefs can also influence the parents not to disclose the HIV status to the children. This is because the discussion will lead to a talk about the issues of sex and sexuality which in most African cultures is considered as taboo. The issues of stigma will always haunt the parents who are living with HIV and AIDS. This ranges from the need to avoid discrimination towards themselves and the infected children to the feeling of guilty for having transmitted the disease to the children. The parents feel that the children may not be able to handle the disease and end up disclosing to their peers and be discriminated and others feel that the children may end up feeling like they are lesser human beings. The fear of blame by the child is a strong contributor. Different parental backgrounds may result in different disclosure patterns. It is however strongly believed that the disclosure of the status to the child improves the adherence to medication. A child who fully understands why he or she is taking the medication is better motivated to take the medication than a child who is taking the medication because ‘it is the right thing to do’. To get an insight into this problem, four sites that are offering HIV treatment to children were randomly selected in Harare. . A cross sectional analytical study was conducted .The target was to do interviews with parents whose children are between the ages of 6 and 16 who will be randomly sampled. One doctor, 2 nurses and 1 primary care counselors who are working in HIV/AIDS clinics for children were also interviewed to get their opinions. These were conveniently sampled. Most parents and health workers claimed that there is a high level of disclosure. However where there is no disclosure the issue of stigmatization and feeling of guilty resulting in self-blame for transmitting the HIV to the child seems like plays a very important role. Some parents also find it difficult to discuss issues of sexuality with their children due to certain cultural back grounds. Most parents will use excuses like the fact that the children are not yet ready. Some parents also fear that the children are not in position to handle the privacy that goes with the illness and may end up disclosing the illness to the communities in the schools where they go and to the other children that they play with. Some fear that their children will be discriminated and also fear that the children will blame them. More women were prepared to disclose than man.
AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die faktore te bepaal wat ouers verhoud om hulle MIV/Vigs-status met hulle kinders te deel. Dit is ‘n groot probleem indien kinders onbewus is dat hulle ouers MIV-positief is en kan tot verskillende onaanvaarbare gedragspatrone aanleiding gee. Bogenoemde gee ook aanleiding daartoe dat sommige kinders selfs teen die ouderdom van 16 jaar steeds nie weet dat hulle ouers MIV–positief is nie, hoofsaaklik as gevolg van die feit dat hulle ouers nie hulle status met die kinders gedeel het nie. Ten einde ‘n beter insig in hierdie probleem te kry, is vier areas in Harare vir die studie geïdentifiseer. Onderhoude is met beide kinders en ouers gevoer. Die ouderdom van die kinders was tussen ses en 16 jaar en deelnemers aan hierdie studie is ewekansig geselekteer. Onderhoude is ook gevoer met ‘n mediese dokter en verpleegster wat met die kinders werk. Alhoewel dit gelyk het dat somminge ouers wel hulle MIV-status met hulle kinders gedeel het, is daar nog steeds ‘n groot groep wat dit nie doen nie. Een van die grootste redes waarom ouers nie hulle MIV-status aan die kinders bekendmaak nie is die vrees vir stigmatisering van die kinders. Voorstelle ter verbetering van hierdie situasie word in die studie gedoen. Indien hierdie probleem nie pro-aktief aangespreek word nie sal dit voortgaan om die effektiewe bekamping van die pandemie te vertraag.