Exploring the psycho-social factors that inform HIV positive status disclosure to children between the ages of 7-14 by their parents and caregivers in Nkangala District of Mpumalanga, South Africa

Abstract

The majority of human immunodeficiency virus (HIV) disclosure research in South Africa has focused on spouses and sexual partners. Few studies have researched how parents and caregivers disclose children’s HIV-positive status to them. Most parents and caregivers of children living with HIV still struggle with status disclosure, which has a negative impact on treatment adherence and the children’s mental and physical health. Understanding the motivations for and against disclosure, as well as how these reasons differ depending on the disclosure target, is crucial for effective preventative actions, such as the tools or practical information parents need. This study explored the social and psychological impacts of HIV-status disclosure to children between the ages of seven and 14 by their parents and caregivers. A qualitative, research design was adopted to achieve the goal of the study. Data were collected through in-depth face to face interviews with 12 participants who were purposefully chosen to participate in the study. Goffman’s stigma theory and literature on parental disclosure of HIV status to children were employed to navigate how stigma contributes to HIV non-disclosure to children by their parents and caregivers and the challenges faced by parents in terms of HIV-status disclosure. The research findings identified three themes: Is it important to disclose, reasons for non-disclosure, and the motivation and procedure for disclosure. Based on the findings, recommendations were developed to assist healthcare providers and policymakers to help parents and caregivers to disclose their children’s HIV-positive status to them. The study’s findings include a consistent pattern of when, how, and what information to convey during disclosure, as described by the parents and caregivers of HIV-positive children who participated in this study.