Mothers’ reasons for refusing to give consent to HIV testing and the outcome in the children

Abstract

Background. HIV/AIDS is one of the most common underlying causes of death in children between the ages of 3 months and 5 years in sub-Saharan Africa. In Limpopo Province, South Africa, the prevention of mother-to-child transmission (PMTCT) programme introduced in early 2000 and paediatric ARV roll-out have had a poor uptake due to various factors.
Objective. To establish the reasons why mothers decline HIV testing for their children.
Methods. A cross-sectional descriptive study was conducted at the paediatric ward, Mankweng Hospital, Limpopo, for a period of 1 year (June 2009 - June 2010). All mothers who had declined HIV testing on their children were requested to participate. All the participants gave informed consent.
Results. A total of 30 mothers participated. All women had attended antenatal care, 28 (93%) stated that their HIV results were negative and 2 (8%) had undergone PMTCT. The reasons mothers refused HIV testing on their children included the following: did not want to be stressed with a positive result (67%), did not want to know their status (7%) and could not consent as their partners had declined tests on both baby and mother (7%); 20% had other reasons including fear of HIV stigma. The median age of the children was 13 months (interquartile range 2 months - 10 years). Twenty-one (70%) of children were discharged home after treatment without HIV testing, five (16%) mothers signed refusal of hospital treatment, three (12%) started ARV after the mother reconsidered and signed consent, with good response to highly active antiretroviral treatment (HAART) and one child died after a month in the hospital.
Conclusion. Fear of being stressed by a positive result was the main reason mothers refused an HIV test on their children. Better education about HIV transmission, prevention and the good response to HAART is needed to increase the uptake of HIV testing and antiretroviral therapy.