Guiding caregivers through disclosure: a qualitative investigation into caregivers’ responses to a disclosure intervention for HIV-infected children in Soweto, South Africa

Awareness of HIV status improves health outcomes in HIV infected children, yet disclosure is often delayed by hesitant caregivers. This qualitative investigation explored how 30 caregivers responded to a HIV Disclosure study conducted between 2017 and 2020 at Chris Hani Baragwanath Academic Hospital, Soweto, South Africa. Caregivers were assisted in disclosing to their children, aged 7-13 years. Following that, a sub-sample of caregivers were interviewed to elaborate on findings.1) Barriers to disclosure included caregivers being ill-equipped, fear of negative consequences and children considered lacking emotional or cognitive readiness. 2) Deflecting diagnosis and the need for medication motivated caregivers to disclosure. 3) Apprehension was evident during disclosure, however, overall disclosure was a positive experience with the assurance and support of the healthcare providers. These results highlight the significant role healthcare providers play in supporting caregivers through the disclosure process and how, in turn, this has a positive impact on the community as a whole.