Disclosure of HIV Status to Children on Antiretroviral Therapy: Perspectives and Experiences of Healthcare Providers in the Masaka Region, Uganda

Abstract

Introduction Disclosure of HIV status to children living with HIV is one of the first steps towards the realization of managing HIV as a chronic disease. This study explored the perspectives and experiences of healthcare providers regarding HIV status disclosure to children taking daily ART in the Masaka region of Uganda. Methods This was a cross-sectional qualitative study that purposively selected healthcare providers offering HIV care and treatment to children aged 12-17 taking daily ART for at least 6 months from one of the HIV clinics in the Masaka region before the study. Data was collected from 18 key informant interviews (KIIs) with healthcare providers between October 2020 and July 2021 and analysed thematically guided by Braun & Clarke's basic thematic analysis steps. Results The findings revealed that providers offering social and psychological spaces for clients (both children and caregivers) to ventilate their issues and having HIV disclosure standards/guidelines at the health facility were key positive factors influencing HIV status disclosure to children. The study also revealed that prioritizing children with high viral loads for disclosure coupled with children being in boarding schools, disclosure role confusion by providers and the absence of disclosure standards at health facilities negatively influenced HIV status disclosure to children on ART in the Masaka region of Uganda. Conclusion There is a need to standardize the HIV status disclosure process for children before, during and after the disclosure including specifying provider roles at every level of the disclosure process. Additional studies are needed to evaluate the school HIV management systems for children, specifically for children in boarding schools.