“It’s my secret:" barriers to paediatric HIV treatment and related health care in rural South Africa

Kimani-Murage Elizabeth, African Population and Health Research Center (APHRC)
Lenore Manderson, Monash University
Shane Norris, University of the Witwatersrand
Kathleen Kahn, University of the Witwatersrand

Without anti-retroviral therapy (ART), half of all children infected with HIV will die before 2 years. Fewer than a quarter of children who need ART receive treatment in sub-Saharan Africa. In this article, we describe barriers to paediatric ART from a community perspective in rural South Africa. Data, drawn from interviews with caregivers of children identified as HIV positive in 2007 were supplemented by discussions with community groups. Socio-demographic data were analysed using Stata. Qualitative data were coded in NVIVO 8 and analysed inductively to identify themes and their repetitions and variations. Paediatric ART and care is limited by poor access to health care, organisational and systems, informational, and social and attitudinal barriers, and to knowledge of a child’s status and concern about discrimination. The results highlight need for interventions to address these barriers, through focused awareness campaigns and interventions to improve livelihoods and access to ART and related care.