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HIV disclosure to children in low-resource countries: a forgotten issue on the international AIDS policy agenda
Presented by Fabienne Hejoaka, France.
F. Hejoaka
EHESS - School of High Studies on Social Sciences, Center of African Studies, Paris, France
Issues: As an increasing number of children are growing up with HIV in low-resource countries, disclosure of HIV infection to children has become a central and challenging psychosocial issue facing by parents and healthcare workers. Despite this fact, HIV disclosure to children as an issue is missing from national and international AIDS policy agendas.
Description: A review of the scientific literature on disclosure of HIV/AIDS to infected and affected children in Western and in low-resource countries was done. The purpose was to make recommendations on a research agenda and intervention approaches.
Lessons learned: Firstly, most studies address issues of prevalence, age, barriers to disclosure and psychosocial impact of disclosure on HIV infected children. However, little attention has been paid to affected children dealing with the disclosure of their parents’ or siblings’ infection. Secondly, although many findings are common to Western and low-resource countries, because 90% of HIV infected children are living in Sub-Saharan Africa, tools and interventions must better consider their social, economic, cultural and prevalence context. Thirdly, specificities related to age, gender, stigma, children’s understanding of HIV/AIDS and their own experience of disclosure, as well as longitudinal studies, need to be further addressed. Finally, there is a paucity of evaluated interventions, recommendations and child-focussed training for healthcare and community workers. Consequently, the burden of disclosure is placed on both parents and children, with little support available to them.
Next steps: There is a need for evaluating interventions, developing disclosure guidelines, providing communication support and training of healthcare and community workers to allow them to support parents in informing their children. National and international AIDS policies have to take significant steps to offer strategic frameworks to increase and improve the disclosure process of HIV/AIDS to infected and affected children.
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