Abstract:
Although HIV/AIDS constitute a significant health burden among children in South Africa, testing
and counselling of exposed children are inadequate. It is therefore imperative that factors
relating to paediatric HCT services offered by health workers are examined. This study was
conducted to explore and describe the perceptions and experiences of trained professional
nurses regarding HIV counselling and testing among children. We conducted six focus group
discussions among trained professional nurses in health facilities in a district in Free State Province,
South Africa. All verbatim transcripts were analysed with a thematic approach and emergent codes
were applied. Forty-seven trained professional nurses participated in the study and two of them
were males. The age of the participants ranges from 38 to 60 years while the median age was 50
years. Most participants in the focus groups explained how HCT occurs during regular health talks
and that lay counsellors are doing most of the counselling. While a few participants thought that
children should not be bothered with HCT, most of them seek consent from caregivers for HIV test
for children. While children whose parents are negative are usually not tested, most children are
tested only when they become ill. Identified barriers to HCT among children include refusal of
consent, work overload, lack of encouragement, and poor record keeping. Participants
recommended improvement of issues relating to community mobilization and increasing trained
staff strength for optimal paediatric HCT service delivery. Developing guidance and policies with
respect to obtaining consent, recruiting more health providers, and addressing structural issues in
the society to reduce stigma and discrimination were identified as key priority issues by majority
of the participants. The perspectives of these participants who provide paediatric HCT services
offer vital insight which may be useful to inform policy interventions.
