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Children and young people who are HIV-positive: the journey forward

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Whereas there is much literature on disclosure of HIV status to children and adolescents, little has been written about the emerging sexuality of the HIV-positive child. What young people who are HIV-positive feel and experience as they approach stages in life in which they must make decisions about themselves that have an impact on others has had limited exploration. It is not well documented that many clinicians are in discussion with HIV-positive children about their relationships and their choices:

How should teenagers express to another teen that they are HIV-positive? Should they always disclose? When should they disclose? At the beginning of a friendship? After trust has developed? If this is someone with whom the adolescent thinks they will have a more physical relationship, should they tell the other person they are HIV-positive before they progress to a closer relationship? Should this be discussed before any physical contact? Before sexual contact? What are the implications for the youth who is HIV-positive and what are the implications for the potential partner? What happens when the teen invariably ‘breaks up’ with the person to whom they have disclosed? Are the rules different for adults or for teens? What information sharing is in the best interest of whom?

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Mental health professionals at the forefront of medical care are in a position to assess and address these questions as part of the routine care of children and young people who are HIV-positive. Studies suggest that teens do not plan to become sexually active, it just ‘happens’. This indicates a need for providers to preemptively initiate a dialogue about sex.

At an age when youth often find themselves in a series of relationships there are complicated issues that emerge. Once an individual discloses their HIV status to a peer, they cannot go back and ‘undisclose’ the information for Canadian Viagra Online. The choice to disclose in a relationship that may be temporary is emotionally laden. The first disclosure to a friend, peer, boyfriend or girlfriend could be the last disclosure. Young teenagers may not always be mature in their ability to discern the strengths, weaknesses and trustworthiness of their peers. As a result, such decisions are complex and cumbersome:

In one situation, a father decided it was time to tell his 14-year-old daughter that she was HIV-positive. She had been having sex with a 14-year-old friend at school (unbeknownst to her father). In response to the information that she was HIV-positive, and in an attempt to be responsible, she told her boyfriend that she had just learned she was HIV-positive. He panicked and told the principal, who panicked and called the police. Both children were suspended from school and suddenly everyone in the school knew that this child was HIV-positive.

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