Experience has shown us that HIV treatment and care is most effective when our clients have a healthy support structure at home. We must address any shortfalls in our clients’ family environment and strengthen community services to ensure our clients do not return to ill health in the long term.
While the child/adolescent is receiving facility-based treatment and care, we identify what psychosocial challenges exist within their home and implement activities to rectify these. We begin this process by delivering direct counselling to the child/adolescent and their caregiver, as most cases require immediate and urgent attention – and a delay would be detrimental to the child/adolescent.
We often find that caregivers are ill-equipped to administer medication, experience food insecurity and are dealing with their own feelings of guilt or shame. At times, personal views and/or beliefs in traditional medicine interfere with the requirement for our clients’ HIV treatment and care to continue at home. Sadly, there are times when abuse or neglect is the problem, and the child/adolescent must be placed with other family members or in a foster home. We use these cases to mentor facility-based healthcare workers on how to establish relationships with the Department of Social Development and/or community networks for ongoing support.
Unfortunately, stigma and misinformation still exist at a community level, and this – combined with the lack of skilled, community-based healthcare workers – results in poor support for a child/adolescent on treatment and their families at home. We are currently identifying activities that will allow us to engage with communities and school health structures that will support HIV prevention, treatment and care strategies.