Help on disclosure to minors available

12 Aug, 2016 - 00:08 0 Views

The ManicaPost

Catherine Murombedzi
DISCLOSURE to spouse or family is often delayed when one tests HIV positive. Harrowing tales were heard at the recently held 21st Aids Conference in Durban where a partner was on medication for years and had never disclosed to the spouse. When taking medication, one needs a buddy who reminds him/her that it is time for pills. When one takes medication in secrecy there is no disclosure and there is a tendency to play hide and seek which can lead to defaulting.

Telling one’s child that the child is HIV positive is one of the most difficult tasks for many parents and caregivers. REPSSI, with the psycho-social wellbeing of children has published a Talking Book Guide for healthcare workers, support groups, caregivers, parents included.

“Disclosure is often delayed which can lead to a breakdown of trust and a burden of guilt, as well as the child being denied access to participate in his or her own healthcare,” writes Natally Woolest, ECHO Psychosocial programme manager.

REPSSI has identified eight programmatic areas to mainstream psycho-social support. These include paediatric HIV and Aids care where knowledge has been generated in collaboration with partners in the countries where they operate from.

“Health care workers in communities and paediatric HIV clinics need tools to assist them to help parents and caregivers to address knowledge gaps related to talking to children safely about the child’s HIV status.

“Health care workers need to be able to help parents and guardians to be able to deal with the fears and anxieties that stop them from being open and honest to their children,” writes Noreen M Huni, REPSSI executive director.

Disclosure is a sensitive issue and a parent or caregiver may want to know when it is the best time to disclose.

“When disclosing for all age groups create an environment where the child will feel free to ask questions. Do not avoid addressing the question that the child may ask. Answer honestly and let the child know if you do not have the answers to that particular question. Let the child lead the discussion in questions and do not try to silence the child but be reassuring,” REPSSI advises.

Children usually believe that illness is their fault so they need reassurance that their illness is not a result of something they have done wrong, the book notes.

After disclosure to the child, monitor the child’s behaviour, sleeping, eating, emotional reactions and school performance. Follow up and seek support if any negative changes persist longer than two or three weeks. Caregiver can always go back to the health care worker for support if they feel they are not coping.

If a child is not coping after disclosure listen to the child again and give space for expression of fears, thoughts and emotions. Gather as much age-appropriate information as possible on HIV and Aids to share with the child and be ready to be asked very difficult questions.

Counselling services are available for free at health centres and if a caregiver feels this is needed they are welcome to go to the clinic. Refer the child for spiritual counselling too.

“When you disclose your status the child should be prepared for stigma and discrimination and explain that it is often from fear and lack of knowledge. Educate the child about his/her own rights and if a school is discriminating tell the child to inform you,” writes REPSSI.

“Fill in the knowledge gaps that the child may have with age-appropriate information. Apologise to the child if they had to find out from some source not you,” notes the handbook.

Disclosure is a process not an event and questions may come from the child for much longer or even for life.

It is hard to accept one’s status and therefore the handbook is handy in helping caregivers and parents on dealing with disclosure to minors.

If a parent or guardian had lied to a child on why they take medication, apologize and assure the child that it was a mistake to hide the information. The child needs to trust the parent or guardian again and saying sorry is the best way to restart a broken relationship.

There are support groups for minors and it is best for the child to know that they are not alone. There is AFRICAID, Zvandiri, Rosaria Memorial Trust, SAY WHAT and many community based organizations that can offer free help.

Check with the health care worker in your area the support that a minor can get in the community. Child friendly corners are often found in most clinics and this can help.

REPSSI has a standardised feedback form and their full list of all the titles in the series can be downloaded from www.repssi.org

Feedback:[email protected]

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