Experiences of Caregivers on Disclosure of Childhood HIV Positive Status to Affected Children in the HO Municipality

Abstract

Disclosure of HIV positive status to children who acquired the infection perinatally is very crucial in their management and has been shown to have numerous benefits. However, HIV status disclosure rates to children living with HIV are still low in low-and middle-income countries. This study explored the experiences of caregivers regarding disclosure of HIV positive status to their children (6-12years) using the Theory of Planned Behaviour. In-depth interviews were conducted with 13 caregivers from two health facilities in the Ho municipality. Participants were selected using a purposive sampling technique. The audio-recorded interviews were transcribed, coded, and analysed using thematic analysis. The findings revealed that caregivers possessed negative attitudes towards HIV status disclosure to children. Most caregivers expressed fear of negative psychological reactions from the children and the ability of children to maintain secrecy. Most caregivers perceived disclosure as a discreet event and so they are delaying disclosure to an older age. Caregivers also reported that they perceived negative normative influence from significant others to disclose. The major barriers identified to be inhibiting disclosure to the children are fear of stigma, discrimination, low self-efficacy, inadequate knowledge on HIV, school-related factors, lack of disclosure teaching and lack of child-focused care at the clinics. Most caregivers said they need nurses’ support to be able to disclose. They cited 17-18 years as the preferred age they intended to disclose. The findings suggest that factors influencing HIV positive status disclosure to children with HIV are multiple, complex, and unique to each family. Family-centred disclosure interventions are needed to address the specific concerns of each family and facilitate safe HIV disclosure to children in this setting. This study offers future research directions on developing protocols for HIV disclosure to children and capacity building approaches for child caregivers. Keywords: Children, Disclosure, Experience, HIV, Caregivers