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Peter Bamwiine grew up taking medication. Whenever it clocked 6:00pm, his mother gave him a tablet to swallow, which left Bamwiine wondering why.

“I demanded an explanation, and my parents always told me that I had a liver disease. They would even threaten that I would die if I did not take my medicine every day,” he narrates.

When Bamwiine turned 14, he lost interest in taking the medicine. Though, still, his parents insisted he takes it, but without an explanation.

Since Bamwiine did not know the importance of taking the medicine, he stopped.

In the months that followed, Bamwiine started falling sick, and his health deteriorated.

This shocked his parents, and they were forced to ask him whether he was taking the medication.

Once again, Bamwiine asked about the use of the medication, but still, his parents could not explain.

He got to know that he was HIV-positive after his parents took him to a counsellor, who disclosed his HIV status.

“I was shocked when the counsellor said I had to take the drugs because I was infected with HIV. I knew HIV was acquired through having sexual intercourse with an infected person,” Bamwine explains.

When to tell your child

Just like Bamwiine’s parents, many struggle to tell children that they are HIV-positive, says Betty Nantambi, a child and adolescent counsellor based in Kampala.

Nantambi says such information can be devastating to a child. Others fear that the children might go telling everyone about their HIV status.

The policy by the health ministry stipulates that by the age of 10 years, parents should be in a position to tell their child their HIV status.

How disclosure is done

John Wamala, also a counsellor based in Jinja, says health workers always encourage parents and caretakers to disclose HIV statuses to the children because they are entrusted to take care of them.

In that case, the health workers often support them by asking questions about HIV in the child’s presence.

For example, they ask them about the diseases they know about.

Through experience, Wamala has noted that HIV/AIDS is mentioned first or second. Thereafter, the discussion focuses on HIV/AIDS while building on the responses as one question leads to another.

Dr. Cordelia Katureebe, the national co-ordinator for paediatrics and adolescent HIV at the health ministry, says the disclosure process should start gradually by preparing the child for the news through talks about HIV/AIDS.

This helps counsellors assess the child’s knowledge about HIV. The child should be made to understand why they have to take medicine and how they acquired the infection.

They should also be told the benefits of taking ARVs.

Additionally, HIV disclosure helps the child adhere to the medication.

Handling the disclosure process

Some adults opt to have the disclosure done in the hospital, but with the support of a health worker.

In the presence of the caretakers and children, the health workers start the discussion and then monitor the child’s response to disclosure, which allows them to know whether to complete the entire disclosure process or push it further.

Betty Nantambi, a child and adolescent counsellor based in Kampala, faults parents who delay the disclosure process, as it makes the children inquisitive.

Consequently, this makes them wonder why they were not told earlier. In addition, the child may react by abandoning treatment, or it may cause anger and bitterness, and correcting it may not be easy, she warns.

Yet if disclosed early enough, the child will appreciate that you love them so much that you choose to share a secret with them.

If the child feels betrayed, the parents can remedy the situation by ensuring they are available for the child and provide answers to all questions.

In the event that the child refuses to take medicine, Nantambi advises parents to engage a counsellor, social worker, or clinical psychologist to counsel the child.