Parents HIV disclosure to children

Paida Mpaso last week wrote an insightful piece on ‘Should parents disclose their HIV status to their children?’ She presented views from parents who had and had not disclosed their statuses and why. Not all families are the same, a number of things need to be considered before disclosing to children.

Parents who choose not to tell their children do so for many reasons: they are in good health and their HIV is being well managed or the children are too young or they do not want to worry their children or cause them any anxiety. 

But there are also compelling reasons to tell children: It is too difficult to hide (drugs, doctors’ appointments, frequent illnesses) or by being open—children can be given appropriate information, support and reassurance or to avoid children finding out in an unsuitable way like through gossip.

Disclosure to children is a major concern that has to be well considered. A few questions that might help whether to disclose: Will the child understand about HIV? How will they react? Can they keep it confidential? How will it affect the family? Is there someone else—a trusted adult—who they can also talk to?

If the decision is to disclose to the child, then parents must prepare and plan. Parents should know what information they want to share, they should disclose in a private, familiar and comfortable environment and be prepared for questions from their children: How did you get it? Are you going to die? Do I have it? Why did not you tell me before? Who else knows? You may choose to tell one child and not the other for many reasons.

When? There is no right or wrong time. Parents know their children best. Children are very intelligent and can sense when something is wrong; so, leaving it for too late can cause them more distress if they know something is up.

Each child is different so how they respond will vary. Some may become angry, anxious, sad, clingy because they are worried that their parent(s) might die soon. They may even become rebellious and turning to drugs and alcohol to act out. It is most likely that their reaction will be temporary.

It is important for parents to be honest and share their feelings with their children and allow children to also openly share how they feel. Children are resilient, have confidence in their ability to cope. They may get upset when they first hear about it but with time, they should come to understand.