Healthcare workers' perspectives and practices regarding the disclosure of HIV status to children in Malawi: a cross-sectional study
- PMID: 29996825
- PMCID: PMC6042360
- DOI: 10.1186/s12913-018-3354-9
Healthcare workers' perspectives and practices regarding the disclosure of HIV status to children in Malawi: a cross-sectional study
Abstract
Background: In 2011 the World Health Organisation recommended that children with a diagnosis of HIV be gradually informed about their HIV status between the ages of 6 and 12 years. However, to date, literature has focused mainly on primary caregiver and child experiences with HIV disclosure, little is known about healthcare workers' perspectives and practices of HIV status disclosure to children. The aim of this study was to assess healthcare workers' perspectives and practices regarding the disclosure of HIV status to children aged between 6 and 12 years in Malawi.
Methods: A cross-sectional survey was used to collect data from 168 healthcare providers working in antiretroviral clinics in all government District and Tertiary Hospitals in Malawi. Participants were asked questions regarding their knowledge, practice, and barriers to HIV disclosure. Data were analysed using binary logistic regression.
Results: Almost all healthcare workers (98%) reported that it was important to disclose HIV status to children. A significant proportion (37%) reported that they had never disclosed HIV status to a child and about half estimated that the rate of HIV disclosure at their facility was 25% or less. The main barriers to disclosure were lack of training on disclosure (85%) and lack of a standard tool for disclosure (84%). Female healthcare workers (aOR) 2.4; 95% CI: 1.1-5.5) and lack of training on disclosure (aOR 7.7; 95% CI: 3.4-10.7) were independently associated with never having disclosed HIV status to a child.
Conclusions: This study highlights the need for providing appropriate training in HIV disclosure for healthcare workers and the provision of standardised disclosure materials.
Keywords: Barriers; Children; Disclosure; HIV status; Healthcare workers; Practice.
Conflict of interest statement
Ethics approval and consent to participate
Ethical approval was obtained from the Malawi Government National Health Science Research Committee (Approval Number: NHSRC 1347) and the Curtin University Human Research Ethics Committee (Protocal Approval HR 186/2014). Informed consent was sought from the study participants prior to data collection. Permission to collect data was also obtained from the District Health Officers and the Directors of the hospitals where data collection was conducted.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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