Disclosing HIV status: Are mothers telling their children?

Objective: Mothers living with HIV face a complex set of child-rearing deci sions, often within the context of many competing stressors. One difficult decision for HIV-infected mothers is whether to disclose their HIV status t o their children. The purpose of this study is to provide information to HI V-affected families and the professionals working with them as they approac h disclosure-related decisions. Methods: Eighty-seven HIV-infected African American mothers and one of thei r children who was not HIV-infected were separately interviewed on two occa sions. Mothers reported whether they disclosed their HIV status to the chil d and provided their assessment of the child's functioning. Children also c ompleted an assessment of their functioning. Results: Results revealed that less than one-third of mothers disclosed the ir HIV status to their children. Disclosure was associated with mother's in come level and perceived severity of physical symptoms. In addition, childr en disclosed to were more often older and female. Contrary to expectation, disclosure was not related to child functioning. Conclusions: Professionals should note the low rate of disclosure among the se families. In the absence of conclusive data regarding impact on child fu nctioning, professionals must remain aware of the complexity of disclosure- related decisions when working with HIV-affected families, particularly in terms of the family and cultural milieu within which families operate.