coping with their loss. An important finding was that adolescents who had a greater number of people providing them with information and emotional support were more likely to use more coping strategies (probably because they were given more knowledge about specific coping strategies) and they were more likely to acknowledge a parent's cause of death as AIDS. Half of the sample named a relative who they said had helped them the most to cope with their parent's death. Eleven of the 20 adolescents reported that they found comfort in talking with other adolescents about their grief. Dillon and Brassard developed a list of systemic ways to help adolescents who have lost a parent to AIDS and they include:
• Along with HIV/AIDS education, teaching about the grief process and the importance of providing social support through forums such as schools, parent- teacher associations, and university departments.
• Offering support groups in schools for adolescents before their parent's death as well as after the parent's death.
• School guidance counselors and school psychologists should be made available to help these adolescents cope with their grief as well as depression.
• Outreach and support should be provided about the importance of giving adolescents the chance to say good-bye to their parents before they die, as well as making arrangements for them to attend their parent's funeral if they wish.
discovered that Prudence was pregnant, despite using condoms. She said: "I do know that is proof that they are not 100% safe." She went to an HIV clinic and was given nevirapine and had a caesarian. Today, her son was 15 months old and had been tested at 6 months and was HIV-negative so far. He will be checked again in a few months to make sure that he is still HIV-negative.
Scant research exists about the experiences of HIV-positive women who desire to have a child. Phurnzile, 19 years old and HIV-positive, desperately wanted to live a normal life and have a husband and children just like everybody else. She asked me whether I thought she stood a chance of one day having her own children and a husband and when I asked if it was important to her, she replied: "la. I would like to feel the sense of belonging to a family - to somebody else." However, she was acutely aware of the possibility that her child could be infected:
I love children... except that since there's no cure for this killer disease.
I'm not sure whether I will ever have my own.. .It's risky, it's risky.
Really, I'm scared! It's risky... When I do that, I would have to be with the love of my life because, really, it's risky...! would have to be financially stable.
She acknowledged that she was not ready right now to have children. Because most of the AIDS-related bereavement literature has focused on gay men, we know little about the experiences of bereaved women who are HIV-positive and raising children. Nomusa remembered when she was told that her six month old daughter was also HIV-positive.
She said:
The person who was supposed to be the counselor told me that children who are born HIV only live until about six years old. Then when she (her daughter) was six years old, I was panicking, panicking - because I knew that when she was six years she could die. I nearly died myself because I was so scared.
For HIV-positive participants, a constant source of anxiety was who would take care of their children after they died. Delarise said that in her workshops with people who feel they may be HIV-positive, the number one issue that is raised is who will look after their children. She said that they also worried about missing the "milestones in their kid's lives or their families." Prudence who had already lost one child, acknowledged that she and her mother occasionally had conversations about what would happen to her 14 month old son if she died:
Sometimes she (her mother) does not feel comfortable with me saying things ... but I know that we have to talk about these things: what I would want to be done when I pass away; I want my son to be taken care of; and who I want to take care of him when I pass away.
Sizakele worried about her deceased siblings' children as well as her own:
As for the children, I think the worst impact is on them because they are relying on us as parents for everything. Now if they wake up not knowing what to do and who to shout at for any help, it's a problem. Every time when I think about it, it gives me such a pain because I think that today it's those children. Tomorrow, my ones are going to be in the same position.
Azon and Sibusiso were the only male participants who had children. Sibusiso worried about the welfare of his youngest child who was less than one year old but he did not express concern over what would happen to his other four children if he died.
However, Azon, together with the other female HIV-positive participants, worried deeply about this issue. Itis interesting that most HIV-positive participants had not spoken with other family members about this issue or made any kind of arrangements with them.
Zanele acknowledged that she did not have a fear of dying, but she worried about what would happen to her six children because her parents were "very old and they will be going soon." She was angry with her husband who had deserted her and her six children.
She said that she saw no future for herself - all she thought of was that some day she would die and she did not know who would take care of her children. Sizakele, too, expressed anger at her husband who she felt she could not rely on to care for her children in the event of her death. She said: "I'm like a person who has no husband. Yes, he is there, but he is useless ... " For Prudence, she knew she could depend on her mother to raise her child, but she worried what would happen if her mother died. Even though her mother was still young (her late 40s), this caused her anxiety: "What if my Mom dies first and maybe I will die after her - what will happen to my son? 1 think about that a lot."
She did not believe that her fiance's family would be of much help as he was not close to any of them, plus his mother "is old now".