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Perception of voluntary screening for paediatric HIV and response to post-test counselling by Nigerian parents
G O Akpede1, R S Lawal, S O Momoh
1University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. akpedeg@yahoo.com
Insights
Understanding perceptions of voluntary HIV testing in Nigerian parents is crucial for developing effective control measures. Many parents are aware of HIV/AIDS but lack knowledge of transmission, impacting testing acceptance.
Area of Science:
- Public Health
- Epidemiology
- Pediatric Infectious Diseases
Background:
- Nigeria faces an evolving Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) epidemic, particularly concerning pediatric cases.
- Voluntary testing and counselling (VTC) for HIV in children and parents is a key strategy for implementing control measures.
- Limited understanding of public perceptions regarding VTC hinders the development of effective counselling guidelines.
Observation:
- A survey of 258 parents of hospitalized children (1 month to 15 years) in Nigeria explored perceptions of VTC.
- Four case studies of seropositive mothers' post-test counselling experiences were analyzed.
- Parents demonstrated high HIV/AIDS awareness (86%) but low knowledge of transmission routes (39%), with none understanding vertical transmission.
Findings:
- 62% of parents would consent to their own HIV screening, and 85% would consent to their hospitalized child's screening based on clinical condition.
- Reasons for refusal included perceived good health, lack of exposure, and despair due to the absence of a cure.
- Fear of family disruption due to HIV-discordant status (seropositive mother, seronegative father) was a significant concern during counselling.
Implications:
- Addressing parental concerns about perceived health, exposure, and treatment availability is vital to enhance VTC acceptance.
- The high prevalence of HIV-discordant couples necessitates tailored counselling and policy development for VTC programs.
- Improved understanding of transmission, especially vertical transmission, is needed to inform public health interventions and parental decision-making.
Abstract:
Nigeria may be taken to represent countries with an evolving HIV/AIDS epidemic. With particular reference to paediatric HIV, the voluntary testing of young children and their parents may provide an important entry point for the institution of control measures. However, there is a paucity of knowledge about how individuals perceive voluntary testing. This knowledge is important to the development of guidelines for counselling. To reduce this gap, 258 parents of hospitalized children (> 1 month to 15 years of age) were interviewed using a structured questionnaire. In addition, to complement the data, four examples of seropositive mother's responses during post-test counselling are presented and analyzed. In the survey, 223 (86%) parents were HIV/AIDS aware but only 88 (39%) of these parents could describe one or more route(s) of transmission and none described vertical transmission. Among the respondents, 153 (62%) of 248 would consent to the screening of self, and 195 (85%) of 230 to the screening of a hospitalized child if based on his/her clinical condition. Perceptions of good health and lack of exposure, and despair owing to lack of a specific treatment, were the common reasons for refusing consent. These represent some of the issues which would need to be addressed to increase the acceptance of voluntary testing. The fear of a break up of families with seropositive mothers but seronegative fathers was a major concern expressed during post-test counselling. HIV-discordance among couples may be frequent and should be considered in the formulation of policies on counselling and voluntary testing.
