FUNCK-BRENTANO et al1 offer a timely and thought-provoking discussion of the patterns of disclosure and perceptions of human immunodeficiency virus (HIV) status in a group of HIV-infected elementary school—age children. The topic is particularly difficult to study, given the degree of ongoing stigma regarding HIV disease and the practical and ethical difficulties of assessing children's knowledge of their illness and psychosocial adjustment in situations in which parents have opted for partial or complete nondisclosure.
Clinical experience and research involving children with other serious, life-threatening conditions, such as cancer, have shown that even young children are aware of the serious nature of their illness and often achieve a precocious understanding of death and personal mortality. This occurs even if the adults have decided not to inform the child of the illness or the potential seriousness of the condition. Many parents feel uncomfortable engaging in open discussions with their children regarding