Experiences of families caring for an HIV-infected child in KwaZulu-Natal, South Africa: an exploratory study

Demmer, Craig

doi:10.1080/09540121.2010.542123

Cited by 51 publications

(78 citation statements)

References 15 publications

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“…It was however not clear whether this was just ignorance or denial. This study is in line with findings from other studies done in developing countries such as South Africa and Ethiopia as only about half knew much about their HIV including their status even when on anti-retroviral therapy which was quiet poor [13]. …”

Section: Discussionsupporting

confidence: 90%

Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana

et al. 2014

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BackgroundIn Ghana it is estimated that 1.2% of HIV infections occur in young people aged 15-24 but the representation in our clinics is small. Adherence to treatment, appointment keeping and knowledge of HIV status remains a challenge. Disclosure has been shown to result in better adherence to therapy, good clinical outcomes, psychological adjustment and reduction in the risk of HIV transmission when the young person becomes sexually active. A baseline study was conducted to ascertain if adolescents and young adults knew their HIV status and their knowledge on HIV. Informed consent and assent were obtained from willing participants. Self-administered questionnaires on general knowledge of HIV, HIV treatment and disclosure were collected and analyzed.ResultsThirty-four young persons participated in the study. The mean age was 16.9 ± SD 2.5 and 62% (21/32) were female. All of them were still in school. Eighty-five percent were aware that young people their age could fall sick, 91% had heard of HIV, 70% knew someone with HIV and 45% thought that adolescents were not at risk of HIV. On modes of HIV transmission, 66.7% knew HIV was transmitted through sex and 63.6% knew about mother to child transmission. Fifty three percent (18/34) knew their HIV status, 50% (17/34) were on antiretroviral and 35% (6/17) of them admitted to missing ARV doses. One person who said he was HIV negative and another who did not know his status were both on ARVs.ConclusionDisclosure of HIV status to adolescents and young people is dependent on a complex mix of factors and most practitioners recommend an age and developmentally appropriate disclosure. Thus it is highly individualized. The knowledge and awareness of HIV was 91% compared to 97% of adults in the most recent Ghana Demographic and Health Survey however only about two thirds had acceptable in depth knowledge on HIV. Only half knew their HIV status which was not the best considering their ages. There is the need to strengthen education to young persons with HIV, support adhere to ARVs for better outcomes and assist care givers to disclose HIV status to them.

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Section: Discussionsupporting

confidence: 90%

Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana

et al. 2014

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“…In this case HIV stigma and discrimination intersected with socio-economic disadvantage which have been described in the South African literature [26,28], but none of the participants experienced similar treatment. This demonstrates how HIV stigma and discrimination operates at many levels – within the social group as well as at individual behaviours [5,16].…”

Section: Resultsmentioning

confidence: 94%

Managing and resisting stigma: a qualitative study among people living with HIV in South Africa

Abrahams

Jewkes

2012

Journal of the International AIDS Society

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BackgroundLiving with HIV is of daily concern for many South Africans and poses challenges including adapting to a chronic illness and continuing to achieve and meet social expectations. This study explored experiences of being HIV-positive and how people manage stigma in their daily social interactions.MethodsUsing qualitative methods we did repeat interviewed with 42 HIV-positive men and women in Cape Town and Mthatha resulting in 71 interviews.ResultsHIV was ubiquitous in our informants’ lives, and almost all participants reported fear of stigma (perceived stigma), but this fear did not disrupt them completely. The most common stigma experiences were gossips and insults where HIV status was used as a tool, but these were often resisted. Many feared the possibility of stigma, but very few had experiences that resulted in discrimination or loss of social status. Stigma experiences were intertwined with other daily conflicts and together created tensions, particularly in gender relations, which interfered with attempts to regain normality. Evidence of support and resistance to stigma was common, and most encouraging was the evidence of how structural interventions such as de-stigmatizing policies impacted on experiences and transference into active resistance.ConclusionsThe study showed the complex and shifting nature of stigma experiences. These differences must be considered when we intensify stigma reduction with context- and gender-specific strategies focussing on those not yet on ARV programmes.

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“…Most studies relied on small samples, with the largest two studies including 492 HIV-infected children and adolescents [48] and 390 caregivers [44]. Eighteen studies used a qualitative study design including interviews or focus groups [30,32,34,35,37,39–43,47,49,51–56]. Six studies included only children and adolescents [17,31,48,50,53,57] and eight studies included only caregivers (parents or guardians) [25,37,38,42,45,51,55,58].…”

Section: Resultsmentioning

confidence: 99%

Disclosure of HIV status to children in resource‐limited settings: a systematic review

Vreeman

Gramelspacher

Gisore

et al. 2013

Journal of the International AIDS Society

208

264

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IntroductionInforming children of their own HIV status is an important aspect of long-term disease management, yet there is little evidence of how and when this type of disclosure takes place in resource-limited settings and its impact.MethodsMEDLINE, EMBASE and Cochrane Databases were searched for the terms hiv AND disclos* AND (child* OR adolesc*). We reviewed 934 article citations and the references of relevant articles to find articles describing disclosure to children and adolescents in resource-limited settings. Data were extracted regarding prevalence of disclosure, factors influencing disclosure, process of disclosure and impact of disclosure on children and caregivers.ResultsThirty-two articles met the inclusion criteria, with 16 reporting prevalence of disclosure. Of these 16 studies, proportions of disclosed children ranged from 0 to 69.2%. Important factors influencing disclosure included the child's age and perceived ability to understand the meaning of HIV infection and factors related to caregivers, such as education level, openness about their own HIV status and beliefs about children's capacities. Common barriers to disclosure were fear that the child would disclose HIV status to others, fear of stigma and concerns for children's emotional or physical health. Disclosure was mostly led by caregivers and conceptualized as a one-time event, while others described it as a gradual process. Few studies measured the impact of disclosure on children. Findings suggested adherence to antiretroviral therapy (ART) improved post-disclosure but the emotional and psychological effects of disclosure were variable.ConclusionsMost studies show that a minority of HIV-infected children in resource-limited settings know his/her HIV status. While caregivers identify many factors that influence disclosure, studies suggest both positive and negative effects for children. More research is needed to implement age- and culture-appropriate disclosure in resource-limited settings.

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Experiences of families caring for an HIV-infected child in KwaZulu-Natal, South Africa: an exploratory study

Abstract: In South Africa, 2

Cited by 51 publications

References 15 publications

Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana

Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana

Managing and resisting stigma: a qualitative study among people living with HIV in South Africa

Disclosure of HIV status to children in resource‐limited settings: a systematic review

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