title: When the time comes to talk about HIV: factors associated with diagnostic disclosure and emotional distress in HIV-infected children.
abstract: OBJECTIVE
  To determine factors related to the timing and probability of nondisclosure of HIV status to perinatally HIV-infected children, and to explore factors associated with emotional distress in HIV-infected children.
  
  
  METHODS
  This is a cross-sectional study of 51 HIV-infected children based on medical records, parent interviews, and child assessments.
  
  
  RESULTS
  1) Probability of earlier age of disclosure is associated with higher child IQ (p =.04) and more family expressiveness (p =.01); 2) controlling for child age, disclosure status at time of study is associated with major life events, but not with medical status; and 3) factors associated with increased parent-rated anxiety in HIV-infected children in univariate analyses are: HIV disclosure (p =.04), other major life events (p =.001), higher medication dose frequency ( p=.01), and child age (p =.01). Increased depression is associated only with more medication doses (p =.02).
  
  
  CONCLUSIONS
  These data indicate that higher child IQ and greater family expressiveness increase the probability of earlier diagnostic disclosure to HIV-infected children. Factors associated with emotional distress highlight important areas of clinical attention. These data suggest that diagnostic disclosure may not necessarily minimize emotional distress, indicating the need for further evaluation of the appropriate timing and type of disclosure for pediatric HIV.
authors.affiliation: Center for Community Health, Department of Psychiatry, University of California, Los Angeles 90024-1759, USA. plester@mednet.ucla.edu
authors.forename: Patricia
authors.initials: P
authors.lastname: Lester
authors.forename: Margaret
authors.initials: M
authors.lastname: Chesney
authors.forename: Molly
authors.initials: M
authors.lastname: Cooke
authors.forename: Robert
authors.initials: R
authors.lastname: Weiss
authors.forename: Patrick
authors.initials: P
authors.lastname: Whalley
authors.forename: Berenice
authors.initials: B
authors.lastname: Perez
authors.forename: David
authors.initials: D
authors.lastname: Glidden
authors.forename: Ann
authors.initials: A
authors.lastname: Petru
authors.forename: Alejandro
authors.initials: A
authors.lastname: Dorenbaum
authors.forename: Diane
authors.initials: D
authors.lastname: Wara
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001007:Anxiety / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013315:Stress, Psychological / Q000209:etiology; D014342:Truth Disclosure