PUBLICATION: AIDS care
Kimani-Murage, E.W., Manderson, L., Norris, S.A., & Kahn, K.
In South Africa, a third of children born are exposed to HIV, while fewer undergo an HIV confirmatory test.
Anti-retroviral therapy (ART) coverage among children remains low-despite roll-out of the national ART
programme in South Africa in 2004. This study sought to understand critical barriers to seeking HIV-related care
for children in rural South Africa. Data presented in this article derive from community-based qualitative
research in poor rural villages in north-east South Africa; this includes 21 in-depth interviews in 2008 among
caregivers of children identified as HIV-positive in 2007 from a randomly selected community-based sample.
Using NVIVO 8, data were coded and analysed, using a constant comparative method to identify themes and
their repetitions and variations. Structural barriers leading to poor access to health care, and social and systems
barriers, all influenced paediatric HIV treatment seeking. Of concern was the expressed need to maintain secrecy
regarding a child’s HIV status to avoid stigma and discrimination, and misconceptions regarding the course of
HIV disease in children; this led to a delay in seeking appropriate care. These barriers need to be addressed,
including through focused awareness campaigns, improved access to health care and interventions to address
rural poverty and development at both household and community levels.
Elizabeth is a Public Health Specialist and is currently heading a project on maternal, infant and young child nutrition (MIYCN), aimed at determining the effectiveness of a community-based intervention to promote optimal infant and young...