Therapeutic Education: Recommendations Regarding Disclosure of HIV Status to Children under ARV in MSF Projects is a document developed by Médecins sans frontières, in 2005. It focuses particularly upon the objectives and means of disclosure of pediatric HIV. The general objective in the care of HIV in the child could be defined as the following: To help the child to grow and develop despite his illness, and to live as well as possible, through a structured and structuring care environment. The general objective will be attained if more specific objectives are worked upon such as: 1) to help the child to develop, to live and to project himself into the future through a life project and according to his own norms of "health", not to reduce the child to his illness; 2) to help the child manage his emotions in the face of his disease, to develop a positive attitude; 3) to liberate the child's thoughts and speech in the absence of his parents, to offer him the possibility to express his fears, anxieties, to talk about his seropositivity. The presence of parents may block such expression; 4) to bring up undermining secret, unsaid and "forbidden" subjects in consultations; 5) to act as intermediary between the child and his parents; to facilitate communication between them; 6) to tackle and permit the expression of death anxiety; 7) to help (older) children to make choices and to take decisions to improve their quality of life; 8) to help the child to understand his health status, his illness and the necessary treatment; 9) once his cognitive development permits it, to involve the child in the taking of his treatment and thus to render him partly responsible for his adherence to treatment; 10) to work with the child upon his self-esteem, issues of stigma, and his place in society; 11) to evoke the question of secrecy: should he tell others that he is on treatment or not? If so, to whom?
Médecins sans frontières
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