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

Categories of disclosure status

Disclosed Partially disclosed Not disclosed

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

QUESTIONS ….