Perceptions and barriers to disclosure of HIV status of children by caregivers at Donkerhook clinic, Windhoek, Khomas region, Namibia
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Date
2025
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University of Namibia
Abstract
Children HIV disclosure remains a complicated process influenced by caregivers’
perceptions, emotional readiness, stigma, and access to support systems. This study
investigates the factors affecting caregivers’ decisions regarding HIV status disclosure to
children, with a particular focus on barriers, facilitators, and the role of structured
disclosure programs. Grounded in the Social Ecological Model (SEM), the study applied
a qualitative research design, using in-depth interviews with caregivers and healthcare
providers at Donkerhoek Clinic, a local health facility in Windhoek, Namibia. Thematic
analysis was conducted to identify key patterns in disclosure practices, emotional
responses, and support mechanisms. Findings indicate that while some caregivers
recognize the benefits of early disclosure, many opt for a delayed or phased approach due
to concerns about the child's mental ability to understand their diagnosis, fear of emotional
distress, and societal stigma. Limited access to structured disclosure counselling and
inconsistent healthcare support further hinder disclosure efforts. On the other hand,
caregivers with access to healthcare-led disclosure programs and peer support groups
reported greater confidence and improved disclosure outcomes. The study also highlights
that stigma remains a persistent barrier, emphasizing the need for community-driven
interventions to promote positive disclosure environments. These findings highlight the
necessity of integrating structured disclosure frameworks into children's HIV care
services. Strengthening healthcare provider training, increasing caregiver support
networks, and developing culturally sensitive disclosure strategies can facilitate timely
and effective disclosure. Future research should explore children’s post-disclosure
experiences and the long-term psychosocial impact of disclosure on their well-being. By
i
addressing these gaps, the study contributes to a more comprehensive understanding of
children's HIV disclosure changing aspects and informs policy recommendations for
improved disclosure practices in Namibia
Description
A research submitted in partial-fulfilment of the requirement for the degree of Master of Public Health
Keywords
Peer Support Networks, Stigma, Antiretroviral Therapy, Community Perceptions, Social Ecological Model, Namibia, University of Namibia