The context and process of pediatric HIV disclosure

When a child is living with HIV, many issues surround disclosure, such as: Who should disclose to the child? Where should disclosure take place? At what age should the child be disclosed?  While guidance exists on what should be done, this study looked at the actual practice of disclosure with 34 caregivers of children living with HIV in Nigeria to better understand the impetus, the process, the context and the people involved in disclosure with the child.  The most common reason for disclosure was to respond to a child’s question about drug regimens and it was most often an impromptu, one time event.  Disclosure was usually in the home or a private setting, but often involved all siblings or affected children in the same discussion.  This study adds to the body of evidence around pediatric disclosure and signals the need to increase disclosure skills with caregivers.