Disclosure of the diagnosis of HIV/AIDS to children born of HIV-infected mothers

HIV disease in perinatally infected patients is now treated as a chronic il lness of childhood. The effective use of highly active anti-retroviral ther apy has contributed to the improvements in the prognosis of this illness. A s this population matures, the issue of disclosure of diagnosis becomes mor e significant and part of their comprehensive medical care. The importance of disclosure relates directly to medication adherence, treatment complianc e, sexual exploration, fears associated with premature death, and the child 's developing autonomy. Disclosure of HIV disease to an infected child pose s complex issues, such as transmissibility, maternal guilt, more than one f amily member with the virus, and the potential for social stigma and isolat ion, among others. A change in perspectives is currently taking place regar ding the process of disclosure, whereby it may be approached as a gradual d iscussion process over the life of the child. A method of gradual and parti al disclosure to the child with consistent support by a multi-disciplinary team of providers has been a successful strategy for many children cared fo r at the New York Hospital-Cornell University Medical Center. Of 73 perinat ally HIV-infected children who are 6 years of age or older, 41% have had co mplete disclosure and another 19% are partially disclosed. Continuous commu nication and negotiation among the members of the team, which includes the parents and caregivers, are vital to the gradual process leading to complet e disclosure.