|Investing in Our Future: Psychological support for children affected by HIV/AIDS. A case study in Zimbabwe and The United Republic of Tanzania (UNAIDS, 2001, 77 p.)|
|Helping parents to disclose their HIV status|
The views of parents differ on whether or not to disclose their HIV status. Disclosure is primarily dependent on how secure the parent is about the HIV-positive status. If the parent is not yet comfortable with being HIV-positive, HIV/AIDS education will not be shared positively with the child and may make the child feel uncomfortable with the information.
Disclosure can also depend on the age of the child. Dr Hores Isaac Msaky, a paediatrician in Dar es Salaam, United Republic of Tanzania and head of ANNEA, says that children around the age of seven are mature enough to understand the finality of death and they have heard about HIV/AIDS in the community or at school. At that age children do not understand the stigma attached to the virus because they do not understand the implications of sexual transmission. The maturity of children and how curious they are about the virus can also affect disclosure.
When Chipo Mbanje told her 11-year-old son that she was HIV-positive, she was surprised to find out that the child suspected this already. Because he didnt really know what that meant and didnt feel he could ask her, he had spent lots of time with the fear that she would die any day. Every headache she had caused much stress for the child; he even saved up Zim$10 (US$0.20) and sent it to her from boarding school to help her out.
Some parents say disclosure is necessary because children with information can protect themselves from contracting the virus when caring for an infected parent. Because the carer has such intimate contact with the infected person, it is possible that opportunistic infections or even HIV itself can be passed to the carer if proper precautions are not taken. Others argue that knowing about HIV in the family just makes the childs life harder. Eventually, it remains the decision of the individual.
Below are the experiences of two orphans. One was not told that her parents died of AIDS, while the others mother told him that she was HIV-positive:
A young girls parents died a few years ago. First, her mother had a baby who died soon after it was born. This girl saw on the babys death certificate that she died of AIDS. Soon after, her mother died, but on the death certificate it said pneumonia. Following her mothers death, her father also became sick and she cared for him day after day until he died. On his death certificate, it said he died of tuberculosis.
Today, years later, this teenager is concerned that her parents may have died of AIDS. She has learned about the virus in school and put two and two together. She is worried that because she cared for her father and came into contact with his blood, she may also be infected but she doesnt feel comfortable talking to anyone about it because she doesnt want to be stigmatized.
16-year-old girl, Bulawayo,
When my mother told me she has HIV I felt like crying and went to sleep. She explained that shes not dying but at first thats what I thought. Now I feel like I have to be there for her in everything, doing housework, cleaning, sweeping.
Sometimes I wish she hadnt told me. I dont like talking about HIV. Im tired of talking about it - I just dont want to keep spending time on it. I dont talk to others about my mothers HIV because it stigmatizes me, but I did talk to my teacher because I had to talk to someone.
Marshall, age 13, is the eldest of his siblings. Harare, Zimbabwe
Whatever is decided about disclosure, an HIV-infected parent must focus on living positively with the virus rather than on dying. There are many ways people with HIV can prolong their lives, including a better diet and a positive attitude. By facing the virus positively, parents can stay healthy longer and keep their children from becoming orphans for as long as possible.