Assessing the Relevance of Ethical Positive Parenting

Impact on HIV Care Quality for Adolescents in Malawi

H. Nasona, L. Phiri, K. Mwitwa, I. Mataya,
S. Solom, S. Neege, A. Ngambi, P. Mbulaje,
P. Damiano, C. Udedi
Malawi AIDS Counselling and Resource Organisation (MACRO)
Presented at IAS 2025 Conference

Background

Adolescents living with HIV (ALHIV) in Malawi face significant challenges including mental health issues, stigma, discrimination, and non-adherence to ART. Caregivers often lack ethical parenting skills needed to address these challenges. Cultural norms further impede discussions about sexuality and HIV-related care, creating gaps in psychosocial support, adherence, and disclosure. Ethical positive parenting advocacy could bridge these gaps and strengthen outcomes across the UNAIDS 95-95-95 cascade.

Intervention

In 2024, we conducted a training program for 50 participants (16 healthcare professionals, 26 peer supporters, and 8 young mentor mothers) addressing:

  • Disclosure challenges
  • Adherence support
  • Community attitudes
  • Caregiver roles in supporting ALHIV

We used pre/post-training assessments and Focus Group Discussions (FGDs) to evaluate knowledge, attitudes, and experiences with ethical parenting.

Key Findings

Pre-training assessment revealed:
• 69% of ALHIV with treatment interruptions lacked stable caregiver support
• 50% reported caregivers' inability to practice ethical positive parenting
• 67% experienced stigma/discrimination affecting mental health and adherence

Post-training findings showed:
• 95% identified lack of truth-telling practices by caregivers
• 87% reported verbal insults as common discipline method
• 70% noted poor caregiver involvement in ART uptake

FGDs identified cultural norms, stigma, and illiteracy as major barriers

Conclusions

Ethical positive parenting is essential for improving HIV care outcomes for ALHIV. The findings highlight the need for community advocacy to address cultural and systemic barriers. Future initiatives should focus on:

  • Empowering caregivers with ethical parenting skills
  • Community education to shift cultural norms
  • Integrated support systems for ALHIV and their families

These approaches can contribute to epidemic control and sustainable HIV care outcomes for adolescents.

Keywords: Adolescents living with HIV, ethical parenting, Malawi, ART adherence, stigma reduction, peer support
Suggested citation: Nasona H, Phiri L, Mwitwa K, et al. Assessing the relevance of ethical positive parenting on the quality of HIV care & treatment services for adolescents living with HIV in Malawi. Malawi AIDS Counselling and Resource Organization; 2024.