Disclosure of HIV Status between Parents and Children in Uganda in the Context of Greater Access to Treatment

ABSTRACT

While disclosure of HIV sero-status is encouraged in the management of the HIV and AIDS epidemic; it remains a challenge; especially among family members. This article examines the moral dilemmas and pragmatic incentives surrounding disclosure of HIV status in contemporary Uganda. Our findings are based on 12 in-depth interviews; 2 focus-group discussions; 6 key informant interviews with AIDS activists; and open-ended responses derived from 148 HIV-positive persons in a quantitative survey. The study was conducted in 2008-2009 in Kampala; Mpigi; and Soroti districts in Uganda. We found both parents and adult children facing dilemmas in disclosure; whether it was parents revealing their own HIV status to their children or the status of their perinatally infected children; or young people infected through sexual intercourse telling their parents. For both groups; there is fear of blame; stigma; discrimination; and shame and guilt related to unsafe sex; while young people also fear loss of privileges. On the other hand; there are practical imperatives for disclosure in terms of gaining access to care; treatment; and material resources. Faced with these dilemmas; HIV-positive people and their families require professional counselling to help them work through the emotional challenges encountered and identify mechanisms of support and coping