Researchers presented several studies involving children with HIV at the 2010 International AIDS Conference in Vienna, Austria. Results showed that HIV appears to have no effect on language development in children, and that children and teens usually handle being told their HIV status well. In addition, New York State and Johns Hopkins University have released new guidelines on disclosing HIV status to children.

Language Impairments Are Not More Common In HIV-Positive Children

This study found that language impairments are no more common in HIV-positive children than in HIV-negative children who have been exposed to HIV and have a similar background.

Language impairment is common in children infected with HIV at birth and often occurs together with cognitive and hearing impairments. However, researchers have been uncertain whether HIV causes developmental problems or if children with HIV are more likely to have impairments because of their socioeconomic backgrounds.

To see if HIV itself causes language problems in children, researchers studied 258 HIV-positive children and 115 children who were HIV negative but had been exposed to HIV. Most of the children were African American (72 percent) or Hispanic (24 percent).

Results showed that children with HIV were not at greater risk of language impairment, with 35 percent of the HIV-positive children and 39 percent of the HIV-negative children diagnosed with language difficulties.

Instead, language problems were associated with ethnicity and the parents’ education levels. The researchers attributed this to the effects of family and socioeconomic factors on language development.

However, since all the children had been exposed to HIV, the researchers could not eliminate this as a risk factor.

Disclosing HIV Status To HIV-Positive Children And Teens

In this Ugandan study, researchers investigated when and how HIV-positive children and teenagers thought they should learn their HIV status. The study also examined the impact of this information on the children and their families.

The study included 187 HIV-positive children between 5 and 19 years old who were interviewed about when and how they had been told they were HIV positive. All contracted HIV by mother-to-child transmission and already knew their HIV status.

Researchers found that children and teens with HIV seemed to quickly accept their HIV status and generally handled the diagnosis very well.

Most of the participants (59 percent) said they were happy with the timing of their disclosure. Children generally wanted to be told their status by close relatives; half said they preferred to learn they were HIV positive from their mothers.

After learning their HIV status, 45 percent of the children and teens reported having felt nothing, while the rest reported short-lived feelings of fear, sadness, anger, or confusion.

Most of the children (77 percent) did not tell others their HIV status following disclosure because of the stigma associated with HIV and AIDS.

In general, parents and guardians also said they were satisfied with the results of disclosure.

The children and teens in the study recommended that HIV-positive children be told their status by 10 years of age.

The researchers supported this recommendation and concluded that the benefits of disclosure to HIV-positive children and teens outweigh the fears of parents and health workers.

New York State And Johns Hopkins Release Guidelines On Disclosure Of HIV Status To Children And Teens

The New York State Department of Health AIDS Institute and Johns Hopkins University announced the release of disclosure guidelines at AIDS 2010 for telling HIV-positive children and teenagers their HIV status.

The researchers emphasized the importance of follow-up to make sure children receive the necessary support after learning their status. The guidelines suggest using age-appropriate and truthful explanations of HIV and AIDS, discussing the child’s concerns about HIV, and clarifying any misconceptions.

They also emphasized that ongoing support is essential for children and teens to adjust well to life with HIV. The researchers advocate for disclosure as an ongoing process with continuing discussions as the child matures, rather than a one-time event.

New York is working on distributing the guidelines more widely to clinicians and caregivers for HIV-positive children and teens.

For more information, please see the AIDS 2010 conference website.