421ed25d5e07.jpgGogo Mazibuko*, a 57 year-old Soweto resident, is a foster parent to a 10 year-old HIV-positive daughter, Nobuhle*.   Nobuhle’€™s mother died of AIDS in 2004 when she was only 2 years and 7 months-old. His father realised that he couldn’€™t take care of Nobuhle and asked uGogo Mazibuko to look after her. Nobuhle’€™s father also died of AIDS in 2007.

‘€œI took her because there was no one else to look after the child. I was not going to sit around and watch a young baby die’€, says Gogo Mazibuko.

When Gogo Mazibuko took the child in she had no idea that she was HIV-positive, but she did suspect because Nobuhle’€™s biological mother had died of AIDS.

‘€œThe child was very ill when she first lived with me. She had bed sores and people thought she was not going to live for long. I took her to Baragwanath Academic Hospital for treatment’€, she says.

Gogo Mazibuko says she experienced a lot of difficulties when she first looked after Nobuhle. She says   she didn’€™t know a lot about HIV at that time and often risked getting herself infected, too.

 ‘€œI used to wash her bed sores with my bare hands, not knowing I had to wear gloves to protect myself.   The doctor asked me to go for a HIV test and I was HIV-negative’€ says Gogo Mazibuko .

Nobuhle is on antiretrovirals. When she was eight years-old, Gogo Mazibuko decided to tell her that she has HIV.

‘€œFirstly, I asked her if she knew why she was taking the medication, and she said ‘€˜no’€™. I then told her. And I also told her that it was our secret and she should not tell her friends at school about it’€, she says.

Gogo Mazibuko says Nobuhle took the news well. She believes it’€™s because the other kids at school don’€™t know about her status. So, she does not get teased or laughed at and she also gets support from her school principal and class teacher who are aware of Nobuhle’€™s HIV status.

‘€œShe has accepted it.   She takes the medication on her own, but I always monitor her.   I even told her that if she happens to bleed when she is playing with other kids, she must never let them touch her and she seems to have understood me’€, says GogoMazibuko.

Nobuhle was lucky to get a foster parent who has taken good care of her health and had the courage to disclose her HIV status to her. Research is in favour of disclosure.   Yet, disclosing to a child his or her HIV status, remains uncommon and burdensome for many parents and care-givers. Care-givers fear HIV-related stigma in the community they live in and believe by not informing a child of their status, they are protecting them.  

‘€œI think parents are concerned by a number of issues, including whether it’€™s the right time to tell a child, whether the child is old enough to know his or her status and how the child is going to respond emotionally’€¦ so, there are a lot of fears around it’€, says Marnie Vojovic a Clinical psychologist from the Children’€™s Rights Centre.

Vojovic says many of the fears that parents or care-givers have around disclosing to a child its HIV status are baseless. She says the younger a child is the better the time it is to tell them. She adds that health care providers should work with care-givers or parents in ways that would help reduce their fears of disclosure and encourage communication between child, care-giver or parent.

‘€œThe care-giver and health care provider need to work together in terms of what approach might be appropriate for that particular child. But, obviously, the earlier the better.   Certainly, when we’€™re looking at children going to adolescence, it’€™s too late,’€ she says.

Vojovic added that a number of children do suspect their HIV status.   She says it’€™s suspecting, but not knowing, that causes so many psychological and emotional problems, as children might not be courageous enough to ask their parents or care-givers about their status.

‘€œChildren who know their statuses… There has been research done that shows they are less depressed, they have self-esteem and are able to develop the coping schemes they need to deal with stigma’€, says Marnie Vojovic.

Emmah Ngidi, a social worker from Cotlands, a children’€™s care organisation, also weighed in on the subject.  

‘€œBiological parents are especially scared to disclose their child’€™s status because they feel guilty for infecting the child from birth. They fear telling the child that ‘€˜I, as a mother, infected you with HIV’€™,’€  she says.

Ngidi says there is no right age to disclose to a child that they are HIV-positive.   But she would encourage parents to disclose a child’€™s status when they are between the ages of 7 to 10 years.

‘€œTelling a child their status at a later stage often results in the child getting depressed. The child tends to resent the parents for not telling them earlier. At the same time, a child will feel that, ‘€˜I am a victim. I didn’€™t do anything wrong. ‘€˜I am not sexually active’€™, because, mostly, they know you get HIV through unprotected sexual intercourse’€, concludes Ngidi.

* Their real names have been changed to protect the minor.