Nondisclosure of HIV status in adolescence

A marked decline of disclosure age for HIV positive youth is greatly influenced by the increase in long-term survival due to the introduction of highly active antiretroviral therapy (HAART) and the concomitant reduction in social stigma. Nevertheless, there are still significant numbers of young adolescents that are receiving treatment without having their HIV positive status disclosed to them. This chapter reviews studies of caregiver and health care provider preferences and hurdles for disclosure, as well as cultural patterns that strongly influence how and by whom HIV diagnosis disclosure is being provided. Disclosure of HIV infection status to young adolescents and symptomatic children is strongly recommended. All adolescents should know their HIV status and should be fully informed and counseled about all aspects of their health, including their sexual behavior. Physicians should encourage adolescents to involve their parents in their care.