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[Acceptability of HIV testing provided to infants in pediatric services in Cote d'Ivoire, meanings for pediatric
Maxime Oga1, Hermann Brou, Hortense Dago-Akribi
1a Sociologist at the Pacci Program Site ANRS , Abidjan, Côte d'Ivoire.
Insights
Pediatric HIV testing acceptance by parents is influenced by healthcare workers' communication, mothers' knowledge, and spousal communication. Fathers play a crucial role, acting as either an obstacle or facilitator to infant HIV testing.
Area of Science:
- Pediatric infectious diseases
- Public health
- Social sciences in medicine
Context:
- HIV testing in children has historically received limited research attention, focusing more on diagnostic tool performance than parental acceptance.
- Understanding parental decision-making is crucial for improving pediatric HIV testing rates.
Purpose:
- To investigate the factors influencing parental acceptance of pediatric HIV testing in infants under six months old.
Summary:
- Parental acceptance of pediatric HIV testing is shaped by healthcare workers' communication and knowledge, mothers' own understanding of HIV and its implications for their well-being, and the couple's communication dynamics regarding the test.
- The father's opinion significantly impacts the decision, with his opposition potentially hindering testing even if the mother agrees, while his support can facilitate it.
- Effective pediatric HIV testing requires addressing not only the mother's perspective but also involving the father and improving communication within the couple and with healthcare providers.
Impact:
- Findings highlight the need for a family-centered approach to pediatric HIV testing, emphasizing spousal communication and healthcare provider training.
- Recommendations include redefining HIV/AIDS strategies for exposed families and actively involving fathers to enhance test acceptance for both parents and children.
Problem:
HIV testing in children had rarely been a central concern for researchers. When pediatric tracking retained the attention, it was more to inform on the diagnosis tools' performances rather than the fact the pediatric test can be accepted or refused. This article highlights the parents' reasons which explain why pediatric HIV test is accepted or refused.
Objective:
To study among parents, the explanatory factors of the acceptability of pediatric HIV testing among infant less than six months.
Methods:
Semi-structured interview with repeated passages in the parents of infants less than six months attending in health care facilities for the pediatric weighing/vaccination and consultations.
Results:
We highlight that the parents' acceptance of the pediatric HIV screening is based on three elements. Firstly, the health care workers by his speech (which indicates its own knowledge and perceptions on the infection) directed towards mothers' influences their acceptance or not of the HIV test. Secondly, the mother who by her knowledge and perceptions on HIV, whose particular status, give an impression of her own wellbeing for her and her child influences any acceptance of the pediatric HIV test. Thirdly, the marital environment of the mother, particularly characterized by the ease of communication within the couple, to speak about the HIV test and its realization for the parents or the mother only are many factors which influence the effective realization of the pediatric HIV testing. The preventive principle of HIV transmission and the desire to realize the test in the newborn are not enough alone to lead to its effective realization, according to certain mothers confronted with the father's refusal. On the other hand, the other mothers refusing the realization of the pediatric test told to be opposed to it; of course, even if their partner would accept it.
Discussion:
The mothers are the principal facing the pediatric HIV question and fear the reprimands and stigma. The father, the partner could be an obstacle, when he is opposed to the infant HIV testing, or also the facilitator with his realization if he is convinced. The father position thus remains essential face to the question of pediatric HIV testing acceptability. The mothers are aware of this and predict the difficulties of achieving their infant to be tested without the preliminary opinion of their partner at the same time father, and head of the family.
Conclusion:
The issue of pediatric HIV testing, at the end of our analysis, highlights three elements which require a comprehensive management to improve the coverage of pediatric HIV test. These three elements would not exist without being influenced; therefore they are constantly in interaction and prevent or support the realization or not pediatric test. Also, with the aim to improve the pediatric HIV test coverage, it is necessary to take into account the harmonious management of these elements. Firstly, the mother alone (with her knowledge, and perceptions), its marital environment (with the proposal of the HIV test integrating (1) the partner and/or father with his perceptions and knowledge on HIV infection and (2) facility of speaking about the test and its realization at both or one about the parents, the mother) and of the knowledge, attitudes and practices about the infection of health care workers of the sanitary institution.
Recommendations:
Our recommendations proposed taking into account a redefinition of the HIV/AIDS approach towards the families exposed to HIV and a more accentuated integration of the father facilitating their own HIV test acceptation and that of his child.