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Disclosure of HIV diagnosis to children: when, where, why, and how
A C Gerson1, M Joyner, P Fosarelli
1Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, 600 North Wolfe St, Park 327, Baltimore, MD 21287, USA.
Insights
Disclosing human immunodeficiency virus (HIV) infection to children is recommended but not standardized. Lack of disclosure can cause significant psychological harm and social exclusion for HIV-infected children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Child Psychology
Background:
- Recommendations encourage disclosing human immunodeficiency virus (HIV) infection to school-aged children.
- Healthcare providers exhibit inconsistent practices regarding HIV disclosure to children.
- Lack of concrete guidelines hinders effective disclosure processes.
Purpose of the Study:
- To review the literature on HIV disclosure to children.
- To describe a pediatric HIV clinic's disclosure process.
Main Methods:
- Literature review on HIV disclosure.
- Description of a disclosure protocol in a pediatric HIV clinic.
Main Results:
- Wide variation exists in current HIV disclosure practices among healthcare providers.
- Nondisclosure is associated with negative psychological outcomes like anxiety and depression.
- Nondisclosure can lead to social exclusion from peer support and medical camps.
Conclusions:
- Standardized guidelines are needed for HIV disclosure to children.
- Effective disclosure is crucial for the psychological well-being and social integration of children with HIV.
- The described clinic process offers a model for disclosure.
Abstract:
Despite recent recommendations by the American Academy of Pediatrics that strongly encourage disclosure of human immunodeficiency virus (HIV) infection to school-age children, health care providers vary widely in their actual disclosure practices. Concrete guidelines for accomplishing disclosure are not currently available. Nondisclosure can result in a variety of problems, including anxiety, depression, phobias, and exclusion from peer support groups and medical camps. This article reviews the available literature on disclosure of HIV infection to children and describes the disclosure process used in a large, urban pediatric HIV clinic.