Doctors Urge Telling Children
If They Have HIV Infection
By Mike Robinson
Associated Press
CHICAGO (AP) - Children and teens who are infected with the AIDS virus should be told, the nation's foremost group of pediatricians says.
"It's better to approach it in a controlled fashion rather than have a 12-year-old overhear it on the ward: `The child with AIDSin bed No. 3,''' said Dr. Robert Pantell of the University of California at San Francisco.
Pantell is one of the authors of a policy statement from the American Academy of Pediatrics published in the January issue of the journal Pediatrics.
The 55,000-member organization recommended frankness toward HIV-infected children. It said doctors should try to work with the patient's parents to convince them their child should know the truth.
But it stopped short of saying doctors should tell the child over the parents' objections, unless the patient is a sexually active teenager.
The academy said the best way to tell the child is with both doctors and parents present. But it acknowledged some parents may want the doctor to break the news.
It said some doctors have often bowed to the wishes of parents who hope to keep youngsters from knowing they have HIV. The reasons include fear that their youngsters will lose their will to live, become angry with parents who infected them or disclose the information outside the family.
The academy has not previously taken a position on the issue. Doctors said the problem is becoming more serious as the number of youngsters with HIV grows and they live longer.
As of a year ago, there were more than 8,000 reported cases of AIDS in children under 13. The vast majority got the infection from their mothers at birth, and well over half remain alive, doctors said.
The statement cautioned that only preliminary research has been done on the effect of telling youngsters about their condition. But the pediatricians said an initial study shows that those who are told have higher self-esteem and parents who are candid with children are less likely to be depressed.
Health-care professionals who did not participate in writing the statement largely agreed.
"Time and time again we have seen that we think we are sparing the children from something and all we have done is make it more mysterious and more frightening because we were unwilling to talk about it,'' said Dr. Thomas DeStefani, chairman of pediatrics at Loyola University Medical Center.
Dr. Hermann Mendez, a professor of pediatrics at the State University of New York at Brooklyn, echoed the statement's authors in saying that the time and manner of disclosure should match the patient's personality and readiness to know the truth.
"If the child is unable to keep information that belongs in the family within the family, this could result in harm to the family,'' he said.
The statement said that teen-agers, who may be sexually active, must be told the truth to prevent spread of the infection. It said preschoolers are usually interested mainly in what will happen in their immediate future and don't necessarily need to hear the whole diagnosis.