Perspectives and experiences of counselors regarding parental disclosure of their HIV status to children.

Abstract

Background: Parental HIV disclosure is a challenging task for parents living with HIV due to stigma shame and fear of unknown responses from children. Counselors usually offer guidance and counseling on such sensitive issues and help parents with disclosing. However, most parents today are hesitant to disclose their HIV status to their children despite its benefits like; Care, emotional support, child reduction of risky behaviors, treatment support and many others. Objectives: To explore counselor’s perspectives and experiences regarding parental HIV disclosure to their children. Methods: A descriptive qualitative study design was used. In-depth interviews were conducted with 17 counselors. Nine of them were from Gombe and eight from Mpigi hospital’s respectively with an experience of 2 years and above. The interviews were conducted in Luganda and each took15-30minutes. Data was audio recorded, transcribed, translated and content analyzed. The findings were presented in structured narratives. Results: Results were derived from two main themes including experiences of counselors which comprised of three subthemes which were; Disclosure is difficult, approaches and consequences of disclosure. Counselors initiated the topic of parental disclosure to parents. They granted parents time to work through their fears and challenges that were hindering disclosure. When they made up their minds, parents consulted counselors privately for help and guidance. They facilitated disclosure after a parents’ voluntary decision and were successful. They used personal experiences and guided parents on the different methods of disclosure like verbal confessions, keeping and swallowing medicines in open among others. Consequences were positive and negative. Positives included children caring for parents, good behavioral change, relief. Negatives were regrets, crying, and rejection and so on. The second theme comprised of two sub themes; perspectives on disclosure and non disclosure which included; disclosure is good, it prompts children to test, can be used for sex education while non disclosure is burdening, hinders acquisition of help from children, blame to parents, causes poor adherence among others. Conclusion: Counselors initiated parental disclosure to parents and guided parents on the methods of disclosing. Key words: Experiences, perspectives, parental disclosure.