Breaking the news to children living with HIV

Catherine Mwauyakufa, CNS Correspondent, Zimbabwe
(First published in Manica Post)
Parents and guardians with children on anti retroviral therapy (ART) have a lot to consider before initiating them on life-long medication. Medication for diabetes mellitus (DM) is easily explained to a child as compared to those on ARVs. Normally, a child with diabetes will understand the condition better as compared to a child who is HIV positive and has to take ARVs for life.

Medication for diabetes is also for life but usually the child does not ask the difficult question ‘Why me?’. But a child born HIV positive does ask the above question, and parents/guardians find it difficult to answer.

Protective stance

Usually a parent or guardian needs to get help from a trained counsellor. Parents and guardians are  protective of their children’s status which is fully understandable. However, children living with guardians are in a ‘special needs’ category, since most of the guardians are not HIV positive themselves, leaving both guardian and child in need of support from those in the know. Talking from experience of the above, I have had enquiries from guardians seeking advice to help the children get out of the moody periods they usually get in. One uncle, who is a guardian to his late sister’s child, has for the past 4 years brought his niece for counselling sessions during weekends and holidays. This has indeed helped the girl and she is now an ‘A’ Level student with a suppressed viral load and is no longer moody.

Helping hand

The minor changed from being moody after learning that there were more children like her. I referred the girl to an organisation dealing specifically with young people. The organisation Africaid Zvandiri Positive has young people living with HIV (PLHIV) as peer counsellors. The name Zvandiri means ‘acceptance’ in Shona, literary translated As I am. The organisation is expanding to other provinces, since the official head office is in Harare. In areas where they are not present, they refer the patients to other helping organisations found in those areas.

Medic buddy

A child needs a buddy who helps them on, reminding them also that it is time to take medication. Parents/guardians must not lie to the children that they are taking medication for a heart or spinal cord condition. Sooner or later they do finally find out what the medication is for, and then it is even harder to explain why they lied in the first place. In Glen View in Harare we recently lost a secondary school boy after he found out on his own what his medication was for. He stopped taking the ARVs, even though he kept on collecting them from his mother. There are children who lost their parents when they were minors and had no one to look after them. Usually the eldest child, although still a minor, took over the responsibility of raising up the siblings. These children become adults growing up under difficult circumstances.They are referred to as mature minors. They are emancipated minors and can also be HIV positive. Children on the streets are also in this category. However, a mature minor understands the implications of getting siblings tested for HIV, and giving consent for a sibling to start medication. Here the mature minor’s age does not matter but his/her understanding of issues at hand.

If a minor, under the age of 16, heading a household and independent to take decisions for siblings and self, demonstrates understanding of HIV then that minor can consent on his/her own behalf and on behalf of siblings. However, mature minors do need support, because they have been thrown into the deep seas, much ahead of their time. Children in difficult circumstances have often been taken advantage of by those who pretend to offer help. Girls have been impregnated and boys too abused sexually. What these children need is education, livelihood support and a community that lessens their burdens. Mrs Shingi Matogo, one of the founders of Clear Vision, said that it is unfortunate when minors are abused in the name of help. “It is very sad when someone who pretended to help orphans ends up being the abuser. Such people must be reported to the police and let the law take course,” said Matogo. Being HIV positive for minors is a challenge, but at the same time, a mature minor needs a pillar to lean on, and not an abuser.

Catherine Mwauyakufa, Citizen News Service - CNS
April 12, 2017