Do children know their parent's HIV status? Parental reports of child awareness in a nationally representative sample.
OBJECTIVE
To determine the rates and predictors of child awareness of parental human immunodeficiency virus (HIV) status and the effect of that knowledge on children.


METHODS
Interviews were conducted with 274 parents from a nationally representative sample of HIV-infected adults receiving health care for HIV. The outcome measures were parental report of child's awareness of parental HIV status, how others reacted to child's parent having HIV, and reasons for nondisclosure.


RESULTS
HIV-infected parents reported that 44% of their children (5-17 years old) were aware of their parent's HIV status, and parents had discussed with 90% of those children the possibility that HIV or acquired immunodeficiency syndrome (AIDS) might lead to their parent's death. Multivariate analyses revealed that parents with higher income, with an HIV risk group of heterosexual intercourse, with higher CD4 counts, with greater social isolation, and with younger children were less likely than others to report that their child knew the parent was HIV positive. Parents reported that 11% of children worried they could catch HIV from their parent. Reasons children did not know their parent's HIV status included that the parent was worried about the emotional consequences of disclosure (67%), was worried the child would tell other people (36%), and did not know how to tell their child (28%).


CONCLUSIONS
HIV-infected parents often worry about the emotional consequences of disclosure to their children and that their children may tell others. More than a quarter of parents reported not knowing how to tell their children. Clinicians may be able to support and guide HIV-infected parents in deciding whether, when, and how to disclose their infection to their children.
Corona
Rosalie
R
Department of Pediatrics, School of Medicine, University of California, Los Angeles, USA. racorona@vcu.edu
Beckett
Megan K
MK
Cowgill
Burton O
BO
Elliott
Marc N
MN
Murphy
Debra A
DA
Zhou
Annie J
AJ
Schuster
Mark A
MA
D000293:Adolescent; D000328:Adult; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D004644:Emotions; D005260:Female; D015658:HIV Infections; D006306:Health Surveys; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D012919:Social Behavior; D014342:Truth Disclosure; D014481:United States