Disclosing to a child his or her HIV status is an emotionally taxing process that a lot of care givers or parents tend to avoid or postpone. A courageous Soweto foster parent took a bold decision and disclosed to the foster child that the child has HIV
Gogo Mazibuko*, a 57 year-old Soweto resident, is a foster parent to a 10 year-old HIV-positive daughter, Nobuhle*. Nobuhle’s mother died of AIDS in 2004 when she was only 2 years and 7 months-old. His father realised that he couldn’t take care of Nobuhle and asked uGogo Mazibuko to look after her. Nobuhle’s father also died of AIDS in 2007.
“I took her because there was no one else to look after the child. I was not going to sit around and watch a young baby die”, says Gogo Mazibuko.
When Gogo Mazibuko took the child in she had no idea that she was HIV-positive, but she did suspect because Nobuhle’s biological mother had died of AIDS.
“The child was very ill when she first lived with me. She had bed sores and people thought she was not going to live for long. I took her to Baragwanath Academic Hospital for treatment”, she says.
Gogo Mazibuko says she experienced a lot of difficulties when she first looked after Nobuhle. She says she didn’t know a lot about HIV at that time and often risked getting herself infected, too.
“I used to wash her bed sores with my bare hands, not knowing I had to wear gloves to protect myself. The doctor asked me to go for a HIV test and I was HIV-negative” says Gogo Mazibuko.
Nobuhle is on antiretrovirals. When she was 8 years old, Gogo Mazibuko decided to tell her that she has HIV.
“Firstly, I asked her if she knew why she was taking the medication, and she said ‘no’. I then told her. And I also told her that it was our secret and she should not tell her friends at school about it”, she says.
Gogo Mazibuko says Nobuhle took the news well. She believes it’s because the other kids at school don’t know about her status. So, she does not get teased
or laughed at and she also gets support from her school principal and class teacher who are aware of Nobuhle’s HIV status.
“She has accepted it. She takes the medication on her own, but I always monitor her. I even told her that if she happens to bleed when she is playing with other kids, she must never let them touch her and she seems to have understood me”, says Gogo Mazibuko.
Nobuhle was lucky to get a foster parent who has taken good care of her health and had the courage to disclose her HIV status to her. Research is in favour of disclosure. Yet, disclosing to a child his or her HIV status, remains uncommon and burdensome for many parents and care-givers. Care-givers fear HIV-related stigma in the community they live in and believe by not informing a child of their status, they are protecting them.
“I think parents are concerned by a number of issues, including whether it’s the right time to tell a child, whether the child is old enough to know his or her status and how the child is going to respond emotionally… so, there are a lot of fears around it”, says Marnie Vojovic a Clinical psychologist from the Children’s Rights Centre.
Vojovic says many of the fears that parents or care-givers have around disclosing to a child its HIV status are baseless. She says the younger a child is the better the time it is to tell them. She adds that health care providers should work with care-givers or parents in ways that would help reduce their fears of disclosure and encourage communication between child, care-giver or parent.
“The care-giver and health care provider need to work together in terms of what approach might be appropriate for that particular child. But, obviously, the earlier the better. Certainly, when we’re looking at children going to adolescence, it’s too late,” she says.
Vojovic added that a number of children do suspect their HIV status. She says it’s suspecting, but not knowing, that causes so many psychological and emotional problems, as children might not be courageous enough to ask their parents or care-givers about their status.
“Children who know their statuses... There has been research done that shows they are less depressed, they have self-esteem and are able to develop the coping schemes they need to deal with stigma”, says Marnie Vojovic.
Emmah Ngidi, a social worker from Cotlands, a children’s care organisation, also weighed in on the subject.
“Biological parents are especially scared to disclose their child’s status because they feel guilty for infecting the child from birth. They fear telling the child that ‘I, as a mother, infected you with HIV
’,” she says.
Ngidi says there is no right age to disclose to a child that they are HIV-positive. But she would encourage parents to disclose a child’s status when they are between the ages of 7 to 10 years.
“Telling a child their status at a later stage often results in the child getting depressed. The child tends to resent the parents for not telling them earlier. At the same time, a child will feel that, ‘I am a victim. I didn’t do anything wrong. ‘I am not sexually active’, because, mostly, they know you get HIV through unprotected sexual intercourse”, concludes Ngidi.
* Their real names have been changed to protect the minor.
Read this and other stories on Health-e.org.za How do you break difficult news to children?