Diagnosis Disclosure in HIV-Infected Thai Children
Vitharon Boon-yasidhi MD*, Uraporn Kottapat MSc**, Yuitiang Durier MEd**, Nottasorn Plipat MD**, Wanatpreeya Phongsamart MD**, Kulkanya Chokephaibulkit MD**, Nirun Vanprapar MD**
Affiliation : *Division of Child Psychiatry, **Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Increasing number of children with perinatally acquired HIV-infection are now surviving into
school age and adolescence. Disclosure of diagnosis to these children has become an important clinical issue.
Clinical reports and studies from other countries suggest that a significant number of these children have not
been told of their HIV status. The objective of this study was to assess diagnosis disclosure status of perinatally
acquired HIV-infected Thai children.
Materials and Methods : Primary caregivers of 96 HIV-infected children aged 5 years and older were inter-
viewed to assess the child disclosure status and the caregivers reasons to disclose or not to disclose the
diagnosis to the child. The disclosed children were also interviewed to assess perception of their illness.
Results : Nineteen of 96 children (19.8%) had been told of their HIV diagnosis by their caregivers. The mean
age of the disclosed children was 9.6 years. Eighty-four percent of the disclosed children reported perception
of their illness as having HIV infection or AIDS. Common reasons for non-disclosing were concerns that the
child was too young, that the child might be psychologically harmed, and that the child could not keep the
secret. Of 77 non-disclosing caregivers, 54 reported that they plan to disclose HIV status to the children in the
future.
Conclusion : This study demonstrates that diagnosis disclosure was made in only 1/5 of HIV-infected children,
and that most of the caregivers were reluctant in disclosing serostatus to the child. Development of an
appropriate guideline for assisting the caregivers and the children to deal with the difficult disclosure process
is needed.
Keywords : HIV, Children Disclosure Psychological impact
