Psychosocial Issues facing Psychosocial Issues facing Children & Adolescents living Children & Adolescents living
with HIV/AIDS with HIV/AIDS in South Africain South Africa
Overview of Field Placement
University of Kwazulu Natal – School of Social Work & Psychology
Sinikithemba HIV/AIDS Care Centre History Client Population Social Work Department
Areas of Field Work Casework with children and their families
at the SKT Paeds Clinic Casework in SKT HIV/AIDS Care Centre
(Adult clients) Discharge Planning at Mc Cord Hospital
Wards Psychosocial Assessment Paediatric Intake
Form ‘Role of the Social Worker in the Paediatric
Clinic’
Areas of Field Work continued…
Study of disclosure of HIV status to children at the Sinikithemba Paediatric Clinic
Disclosure Policy Disclosure Protocol Guidelines for staff: Working with Children &
Caregivers on Disclosure Trainings Completed:
Certificate in HIV/AIDS Counselling South Africa Department of Health ARV
Training Program for Social Workers Weekly in-service trainings at SKT
Sinikithemba Paediatric Clinic
Multidisciplinary Team Demographics of Client Population Profile of Caregivers
Psychosocial Issues Disclosure Care & Treatment
Financial Support Emotional Support
ARV Adherence Support Community support Grief & Bereavement School Adjustment & Functioning
DISCLOSURE
Normalizing HIV Status
Disclosure: The window to providing for Psychosocial needs of Children & Adolescents
ARV ADHERENCE
STIGMA & DISCRIMINATION
ACCESSING COMMUNITY RESOURCES
GRIEF & BEREAVEMENT
ACCESSING SUPPORTIVE COUNSELLING
PROVIDING FOR SAFETY OF CHILD IN ALL SETTINGS
FORM OF PREVENTION
Disclosure …. the process through which a
child/adolescent receives, and copes with information about his/her HIV status
… a process as opposed to a one-shot dose of information
… continues as SKT supports the child and his/her caregivers to increase their understanding of HIV and learn how the virus behaves in the body
Considerations in Disclosure
Age of Disclosure Formulating a Disclosure Plan Legal & Ethical Issues The Disclosure Process
Decision-Making for Caregivers may decrease the ability of caregivers to control
secondhand disclosure by others Children/adolescents, even though secrecy is
requested, may disclose their status and the status of caregivers to others
Possible increased vulnerabilities for child/adolescents – depression, isolation are some difficulties which he/ she may experience as a result of learning of his/her status
Caregivers who are having difficulties in coping with their own status and illnesses may experience extreme anxiety in the disclosure process
Misconceptions ‘Disclosure will only be necessary if I get
really sick, my child does not need to know.’ Disease Progression instead of an ‘anticipated rewards vs. costs’ approach to disclosure
‘The child just talks too much, she/ he has no control over his/her mouth’
‘My child will kill him/herself if he knew’ ‘If my child asks if she/he has HIV I will tell
him/her no, when he/she gets older they will understand why I did what I did’
‘If my child asks if she/he has HIV I will tell him/her no, when he/she gets older they will understand why I did what I did’
‘Children cannot understand death!’ ‘If my child learns that I gave him/her
HIV he/she will hate me’
Disclosure & the Social Worker’s Role
Psychosocial Assessments Home Assessments Educating Caregivers Building Patient’s competencies for
treating with the progression of the Illness
Building Community resources