Towards a Family-Centered Approach to HIV Treatment and Care for HIV-Exposed Children, Their Mothers and Their Families in Poorly Resourced Settings

Abstract

This article provides a summary of emerging psychosocial evidence relevant to the success of comprehensive family-centered approaches to HIV prevention, treatment, care and support programs in poorly resourced settings. This report synthesizes current evidence on maternal, paternal and family experiences of HIV prevention, diagnosis, treatment, adherence and disclosure, with special focus on HIV-infected mothers and HIV-exposed children. Taking a developmental approach, we explore the current challenges and opportunities towards a family-centered approach within the continuum of HIV treatment and care, beginning in pregnancy and following the course of childhood. The discussion is limited to early and middle childhood and excludes discussion of special issues emergent in adolescence, which would warrant discussion outside the scope of this article. Attention is drawn to the complexity of problems arising within the family context and the need for improvements in the integration of aspects of treatment, care and support. While this article focuses on examples from sub-Saharan Africa, the lessons learnt and future challenges outlined are applicable to most low- and middle-income countries, and to poorly resourced contexts in higher-income countries.

Keywords:

• adherence
• care
• child development
• disclosure
• family-centered
• HIV-exposed children
• HIV-infected mothers
• prevention
• treatment

Financial & competing interests disclosure

The Africa Centre for Health and Population Studies is funded by a core grant from the Wellcome Trust (Grant number 082384/Z/07/Z), and A Stein was supported by the Wellcome Trust (Grant number 071571) (www.wellcome.ac.uk). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

The Africa Centre for Health and Population Studies is funded by a core grant from the Wellcome Trust (Grant number 082384/Z/07/Z), and A Stein was supported by the Wellcome Trust (Grant number 071571) (www.wellcome.ac.uk). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.