Talking to children about their HIV diagnosis: a discussion rooted in different global perspectives.

An online meeting was arranged with four professionals representing four countries to debate current practices and future steps in naming HIV to children (disclosing HIV status). This article considers the evidence and reports on the commentary and debate from the meeting. Naming HIV to children remains a challenge. Although studies identify some of the facilitators and barriers to informing children of their HIV diagnosis, further review of practice is required. This article presents a global perspective of naming practices from different settings. The article comprises commentary and a report of the online debate, along with supporting evidence. The four participating authors concluded that health professionals must work in collaboration with families to support early naming of HIV to children or having an open discussion about HIV in clinics. Naming when a child is younger reduces self-stigma and empowers children and young people to adhere to their medication, make informed decisions and share their own diagnosis appropriately. The authors concluded that health professionals play a key role in educating colleagues and the public to reduce stigma and discrimination. Professionals working with children and families living with HIV require support and resources to instil confidence in naming and facilitate naming of HIV status to a child.

The South African community pharmacy sector-an untapped reservoir for delivering HIV services.

Differentiated service delivery is recommended to improve the uptake of HIV testing and treatment for people living with HIV. One service delivery option yet to be fully capitalised on is community pharmacies. There are approximately 3,580 registered community pharmacies in South Africa. A total of 1,110 (31%) of these pharmacies are corporate chain pharmacies located in cities and towns, the remainder are individually owned, many of which are in less populated poorer settings. Community pharmacies traditionally play a pivotal role in providing health education to the populations they serve and are the first point of contact for people seeking health services, offering more convenient opening hours and shorter waiting times than public sector clinics or private doctors. As a result, patients regularly seek a variety of sexual and reproductive health services at community pharmacies such as self-testing devices for HIV, treatment for sexually transmitted diseases, and an array of reproductive health services, spanning emergency contraception to fertility advice, often signifying HIV risk. This has presented an opportunity for community pharmacies to provide access to HIV prevention and treatment to ensure the targets for HIV services set by international agencies and local government are achieved. Despite obstacles experienced with the expansion of the community pharmacist's role, exploring the potential of pharmacies to mediate the existing challenges with HIV service delivery has emerged as an important resource. Assessing the South African communities' specific HIV treatment needs and willingness to access HIV services from community pharmacies will benefit from additional research.

Positive action. Interview by Carol Davis.

Working with HIV-positive children and their families is immensely rewarding for award-winning nurse Juliet Houghton. But the job requires huge efforts to protect patient confidentiality.