Counsellors’ experiences of HIV status disclosure to children living with HIV in Uganda

ABSTRACT

Reports indicate advancement in the fight against HIV infection. However, the rate of new infections among children, especially in sub-Saharan Africa, remains high. Research findings highlight the benefits of HIV status disclosure to children. Yet, there is limited research concerning the ways counsellors navigate the disclosure process. The purpose of this study was to examine the experiences of counsellors regarding status disclosure to children living with HIV in Uganda. Qualitative research methods guided the individual interviews with 10 counsellors from three HIV care centres. Findings indicated four overarching themes including: counsellors’ roles and responsibilities, impact of age in the disclosure process, motivations for disclosure, and challenges and barriers. Study results highlight the critical role played by counsellors and the need for clear paediatric disclosure guidelines.

KEYWORDS:

• Counselling
• HIV status disclosure
• children
• Uganda

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author (H, O). The data are not publicly available due to restrictions, including that data contains information that could compromise the privacy of research participants, and the consent forms signed by participants did not contain a clause seeking for permission to share data with a public depository.

Ethics approval

Authors received ethical approvals from the institutional review board of the University of North Texas (IRB-19401) and the Uganda National Council of Science and Technology (SS626ES)

Consent to participate

All study participants read and signed the informed consent document prior to their involvement in the interviews.

Consent for publication

The informed consent document included a section on the publication of the study results while protecting personal information and identity of participants.

Availability of data and material

Available upon request.

Authors’ contributions

Author 1 (Harriet Opondo) conducted interviews, transcribed interviews, led and participated in the data coding and analysis, wrote the article.

Author 2: (Natalya A. Lindo): Provided overall supervision of the research project, including mentorship of the first author, reviewing and providing feedback on the manuscript.

Authors 3 & 4 (Hailey B Morris & Haun Chen): Participated in data coding and analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Harriet Opondo

Harriet Opondo Ph.D. specialises in therapeutic interventions with children and their primary caregivers. She is currently a post-doctoral associate at the birth-to-three clinic (an early infant mental health programme) at the Department of Paediatrics, Medical School, University of Minnesota, USA. Her research interests include paediatric HIV status disclosure processes, early childhood mental health, child-caregiver attachment relationships and relational-based parenting interventions. Dr. Opondo, together with mentors at the University of Minnesota, is currently drafting an early childhood mental health programme for implementation in Uganda.

Natalya Ann Lindo

Natalya Ann Lindo, Ph.D., LPC, is an Associate Professor and Department Chair at the University of North Texas, USA, with 15 years of experience as a researcher and clinician with specialised training in working with children and families, diverse and at-risk populations. Her primary research areas are school-based play therapy, child–parent relationship therapy, teacher–child relationship building, and career development across the lifespan. Consistent with this research agenda, Dr. Lindo regularly conducts action-research projects in the public schools. Most recently, Dr. Lindo developed the Child and Adolescent Career Construction Interview aimed at improving self-concept, occupational identity and career adaptability. With a focus on capacity building, Dr. Lindo collaborates with administrators and school counsellors to develop school-wide mental health initiatives targeting children who are at risk for school failure.

Hailey B. Morris

Hailey B Morris MS is a second-year counselling doctoral student at the University of North Texas, USA. Hailey’s research interests include college counselling, integration of multi-cultural aspects into counselling and higher education. Hailey has participated in numerous research projects on varied topics, including clinical supervision and the intersection of marginalised racial and gender identities.

Huan Chen

Huan Chen MS is a third-year counselling Ph.D. student at the University of North Texas, USA. Huan specialises in play therapy and child–parent relationship therapy. Huan’s research interests include play therapy, child–parent relationship therapy with adopted children and international students’ issues. She has collaborated with faculty to research in areas such as international Asian students’ mental health-seeking behaviour and culturally informed clinical supervision approaches.