Introduction
Healthcare services, unfortunately, are not free of pre-existing bias against socially stigmatized illnesses. HIV and AIDS are among these conditions and carry an associated history of discrimination towards the affected due to the sexual transmission of a significant part of the disease cases. Yet, as any immune disorder, HIV is much more complex than that and can be transmitted in a variety of ways that frequently have no connection to sexual intercourse. Specifically, HIV and AIDS can be inherited by children from their parents, subjecting this vulnerable demographic to the severe health consequences and serious discrimination alike. Furthermore, comparatively older children are more difficult to diagnose, since many of them do not experience all or even the majority of symptoms. This research proposal details background information on the existing biases against children with HIV in healthcare, introduces a hypothesis regarding the potential solution to the issue, and elaborates on it.
Background and Need for the Work
HIV/AIDS is a widely stigmatized autoimmune disorder surrounded by a wide variety of misconceptions rooted in fear and an outdated perception of the virus. Over 3.2 million of children worldwide are affected by the virus yet only 24% of the demographic receives antiretroviral therapy (Schlatter, 2016, p. 1-3). Caregivers of the affected children are frequently struggling with guilt and depression, particularly if HIV-positive themselves (Tran et al., 2019). According to the research, an even larger number of children live with undiagnosed HIV, due to both severe social stigma and shortage of HIV-positive adults in healthcare services (McHenry et al., 216). The schools, churches, and other local community institutions frequently fail to provide sufficient education on the disease to the children and teenagers affected.
Problem Statement
As the background information on the issue suggests, there is a prevalent need for further research into effective diagnosis of children and teenagers with HIV. As a vulnerable demographic, this population group requires additional educational resources and support systems, as well as more precise testing mechanisms than the ones currently designed (Kimera et al., 2020). A balance must be found between the medical testing of every child, which is highly inefficient and costly, and the testing of symptomatic children exclusively. The aim of this research is to elaborate on potentially more efficient ways of testing HIV-positive children.
Research Question and Hypothesis
This paper examines the hypothesis that putting children of HIV-positive adults into testing would increase the precision of the diagnosis and address the needs of the vulnerable group. The research recognizes the potential negative ethical implications of such testing, considering the existing social stigma, and aims for it to be a strictly upheld privacy issue. Furthermore, to prevent negative consequences of stigmatization associated with the testing, educational resources must be allocated to hospitals and schools. Early testing for children of HIV-positive adults is necessary to provide the risk demographic with medical care if required but should be accompanied by education and support.
Information from the Literature Review
HIV-positive children and teenagers primarily receive the virus transmission from their parents, which allows medical scientists to hypothesize about the efficiency of the aforementioned mass testing. HIV might be transmitted trough sexual intercourse, drug use, and other blood-affecting channels, yet those are naturally rare for children under 12 years old, who operate as the research demographic. Active referral for testing, according to the literature reviewed, decreases the amount of undiagnosed HIV cases in children and younger teenagers (Wagner et al., 2016, p. 86). To facilitate the existing issues in HIV medication supply, production companies and relevant government officials should be provided with up-to-date information regarding the relevant virus cases. Although the existing studies are not directly comparable, they all demonstrate that simple and systematic interventions decrease the amount of undiagnosed HIV cases within the demographic (Wagner et al., 2016). However, such a complex issue requires attention on any layer, including the continuous systematic support to the tested children.
Literature review demonstrates the existence of strong links between sufficient educational support and the reduction of social stigma around HIV. The caregivers of children and teenagers with HIV are worried that the social status of the victims would be inadvertently affected, resulting in segregation and loss of friends (McHenry et al., 2016). Yet monitored conversations about the issue have shown some effectiveness in facilitating the problem. The review observes that international institutions, such as World Health Organization, often discriminate against affected children more so than local governments (Vreeman et al., 2019). Therefore, one can assume that if sufficient authority on policy-making is allocated to local healthcare services and public officials, social stigma might be effectively decreased. This is the crucial element to monitor if the proposed wide testing of the risk group of children is implemented.
Approach and Methods
HIV-infected parents in HIV care can be systematically asked about their children’s HIV status and testing history, with surveys used as a data collection instrument. Discretion and privacy must be guaranteed by the researchers and doctors involved in compliance with personal data protection regulations. Adults with untested children under 12 years old are to be referred and offered the choice of pediatric HIV testing at home or the clinic. Such study design ensures that only the children between the ages of 1 and 12 of HIV-infected caregivers with the unknown HIV status are referred for testing. This approach would allow medical scientists to quickly study the potential links between undiagnosed HIV in children and their membership in the risk group.
The schools where the tested children are currently pupils are to be supplied with educational materials on the history and transmission specifics of HIV. These materials should be checked in advance to avoid discrimination and stigmatization, as well as the unnecessary sexualization of the virus. Up-to-date information about available treatment tactics should be included in the materials alongside the contact information of relevant social and psychological support services. After a designated time period, children of HIV-positive adults, regardless of the result of their own testing, will be surveyed on the topic of their psychological comfort and experiences with discrimination. Both HIV status of the children from the risk group and their experience in the school environment with the additional support provided are variables of interest. For qualitative approaches, certain data variables (number of children with unknown HIV status, presence/absence of relevant education in their schools etc.) will be converted to tables through the statistical programmes, such as SPSS.
Limitations
On the legislation level, some governments might not allow to include the anti-discrimination materials into their educational policies. School regulations are subject to local authority and differ massively even between local communities, let alone on national and international levels. Due to high levels of social stigma, some parents might object against the education of their children about HIV/AIDS (McHenry et al., 2016). Additionally, certain time is required until the effects of the educational materials manifest, which is an issue considering the prevalence of HIV infections among children.
Furthermore, the testing itself might prove to be an inefficient instrument to guarantee full reliability of the research. As with any scientific study, parental consent is required to hold the initial conversation, which eliminates a sub-set of the risk group in advance. To achieve statistical significance within the sample of parents that do agree to participate, a large sample number is required with the observation of relative balance amongst potential factors of influence. Those include, but are not limited to, race, nationality, sexual orientation, and socioeconomic background of the parents. The accumulation of the necessary sample, as well as the processing of the findings, requires time and potential financial investments.
Expected Findings
Active and systematic testing of children from the HIV risk group is expected to decrease the number of undiagnosed cases within this age demographic. Children of HIV-positive adults and children that are placed in care of HIV-positive caregivers are identified as the risk group due to the specifics of the virus transmission. Findings of the research are to be documented and compared against the expectations and the pre-existing hospital records.
It is also expected that the introduction of educational materials into schools and other community institutions will reduce the existing social stigma around the disease. Schools of the tested children might be informed of the procedure if the consent of the parents and medical discretion is ensured. It is expected that the proper educational materials will ensure comfortable and fair learning environment for children with HIV.
Conclusion
Mass testing is, unfortunately, a logistical requirement when one considers the prevalence of the HIV diagnosis amongst children. Similarly, it is logical to focus on the children of HIV-positive adults as the risk group due to the transmission specifics of the disease. Nonetheless, it important to consider the potential negative social implications and facilitate them through proper educational materials on HIV to ensure equally fair learning environment for those affected.
References
Kimera, E., Vindevogel, S., Reynaert, D., Justice, K., Rubaihayo, J., & De Maeyer, J. et al. (2020). Experiences and effects of HIV-related stigma among youth living with HIV/AIDS in Western Uganda: A photovoice study. PLOS ONE, 15(4), e0232359.
McHenry, M., Nyandiko, W., Scanlon, M., Fischer, L., McAteer, C., & Aluoch, J. et al. (2016). HIV Stigma: Perspectives from Kenyan Child Caregivers and Adolescents Living with HIV. Journal Of The International Association Of Providers Of AIDS Care (JIAPAC), 16(3), 215-225.
Schlatter, A., Deathe, A., & Vreeman, R. (2016). The Need for Pediatric Formulations to Treat Children with HIV. AIDS Research And Treatment, 2016, 1-8.
Tran, B., Ho, R., Ho, C., Latkin, C., Phan, H., & Ha, G. et al. (2019). Depression among patients with HIV/AIDS: Research development and effective interventions (GAPRESEARCH). International Journal of Environmental Research and Public Health, 16(10), 1772.
Vreeman, R., Scanlon, M., Tu, W., Slaven, J., McAteer, C., & Aluoch, J. et al. (2019). Validation of an HIV/AIDS stigma measure for children living with HIV and their families. Journal of the International Association of Providers of AIDS Care (JIAPAC), 18, 58-71.
Wagner, A., Mugo, C., Njuguna, I., Maleche-Obimbo, E., Sherr, K., & Inwani, I. et al. (2016). Implementation and Operational Research: Active Referral of Children of HIV-Positive Adults Reveals High Prevalence of Undiagnosed HIV. JAIDS Journal Of Acquired Immune Deficiency Syndromes, 73(5), e83-e89.