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Healthcare providers' perspectives on discussing HIV status with infected children
Landon Myer1, Keymanthri Moodley, Fahad Hendricks
1Infectious Diseases Epidemiology Unit, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa. lmyer@cormack.uct.ac.za
Insights
Healthcare providers in South Africa recommend disclosing HIV status to children around age 10, emphasizing caregiver support. Early general health talks can begin at age 6.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Disclosure of Human Immunodeficiency Virus (HIV) status to infected children in sub-Saharan Africa is understudied.
- Effective disclosure strategies are crucial for pediatric HIV management and adherence to treatment.
Purpose of the Study:
- To explore healthcare providers' attitudes and experiences regarding HIV status disclosure to children in Cape Town, South Africa.
- To identify optimal timing and approaches for discussing HIV infection with pediatric patients.
Main Methods:
- Conducted 40 semi-structured interviews with healthcare providers at a large pediatric HIV clinic.
- Focused on provider perspectives on age-appropriateness and caregiver roles in disclosure.
Main Results:
- Most providers suggested initiating general health discussions around age 6.
- A median age of 10 years was recommended for specific discussions about HIV infection.
- Primary caregivers were seen as key, but requiring significant support from healthcare professionals.
Conclusions:
- HIV status disclosure to children is complex, requiring tailored approaches.
- Interventions are needed to support both caregivers and healthcare providers in managing these sensitive discussions.
- Further research into effective pediatric HIV disclosure practices in the region is warranted.
Abstract:
The disclosure of HIV status to infected children has received relatively little attention to date in sub-Saharan Africa. We conducted 40 semi-structured interviews with healthcare providers working in a large paediatric HIV clinic in Cape Town, South Africa regarding attitudes and experiences around discussing HIV with infected children. Most providers felt that the optimal age for general discussions about an HIV-infected child's health should happen around age 6, but that specific discussions regarding HIV infection should be delayed to a median of 10 years. Though most providers said that primary caregivers were the most appropriate individuals to lead disclosure discussions, there were strong views that caregivers require support from healthcare providers. These findings indicate the complexities involved in the disclosure of HIV status to infected children, and point to the need for interventions to support caregivers and providers in disclosure discussions.
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