BANGKOK – In 2013, 35 million people were living with HIV. According to the World Health Organization a significant portion of the people, 3.2 million, were children. While the HIV epidemic is worldwide, the majority of infected individuals live in lower income countries.
HIV is particularly dangerous because 19 million of the 35 million people infected with HIV are not aware of it. This statistic includes children who have been born HIV positive.
In Thailand, 13,000 children are infected with HIV, but many are not made aware of their status. A study implemented by the Mahidol University in Thailand, indicates, “80% of HIV infected children older than 7 years had not been told of their HIV diagnosis.”
HIV can be transmitted from mother to child via pregnancy, labor, childbirth, and breastfeeding. The consequences for avoiding disclosure of HIV status to children at the appropriate time are devastating.
If a child is not made aware of his/her status before puberty and sexual behavior, then it is likely that the virus will spread throughout the community.
In addition, when parents decide not to reveal HIV status to their children there is a chance that the child can determine their status anyway. Children can draw the conclusion of their HIV positive status through routine visits to the doctor and medication that parents provide for them.
When an HIV positive status is treated as a secret, feelings of confusion and insecurity can arise within the child. The secrecy creates additional stigma around HIV that creates a barrier to treatment access. The National Institutes of Health cites emotional distress and social isolation as potential consequences. Furthermore, these effects could lead to a lack of participation in antiretroviral therapy.
An HIV counseling program implemented in Bangkok, Thailand to disclose HIV status to children works to support families and children. The program is structured around four critical steps: identify, assess, disclose, monitor and evaluate.
Parents fear disclosure of HIV status to their children because of guilt, blame, and anxiety that children will refuse to take the necessary medication. The counseling program works directly with children and their caregivers to alleviate parental fears and improve child self-esteem.
The results from this program indicate that the counseling model had a “positive effect on the children’s mood and quality of life and no negative effect on children’s behaviors”. The program has been recommended for expansion due to its success.
In addition to the health complications facing HIV positive adults and children, the epidemic has negatively impacted economic growth and development of communities. Programs that support those affected by HIV and work to reduce stigma around this health issue can reverse these trends.
– Iliana Lang
Sources: AIDS.gov, CDC, National Publication for Biotechnology Information, Mahidol University