J Med Assoc Thai Vol. 88 Suppl. 8 2005 S100 Correspondence to: Vitharon Boon-yasidhi, MD, Division of Child Psychiatry, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. e-mail: sibvy@mahidol.ac.th Diagnosis Disclosure in HIV-Infected Thai Children Vitharon Boon-yasidhi MD*, Uraporn Kottapat MSc**, Yuitiang Durier MEd**, Nottasorn Plipat MD**, Wanatpreeya Phongsamart MD**, Kulkanya Chokephaibulkit MD**, Nirun Vanprapar MD** *Division of Child Psychiatry, **Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Background: Increasing number of children with perinatally acquired HIV-infection are now surviving into school age and adolescence. Disclosure of diagnosis to these children has become an important clinical issue. Clinical reports and studies from other countries suggest that a significant number of these children have not been told of their HIV status. The objective of this study was to assess diagnosis disclosure status of perinatally acquired HIV-infected Thai children. Material and Method: Primary caregivers of 96 HIV-infected children aged 5 years and older were inter- viewed to assess the child disclosure status and the caregivers reasons to disclose or not to disclose the diagnosis to the child. The disclosed children were also interviewed to assess perception of their illness. Results: Nineteen of 96 children (19.8%) had been told of their HIV diagnosis by their caregivers. The mean age of the disclosed children was 9.6 years. Eighty-four percent of the disclosed children reported perception of their illness as having HIV infection or AIDS. Common reasons for non-disclosing were concerns that the child was too young, that the child might be psychologically harmed, and that the child could not keep the secret. Of 77 non-disclosing caregivers, 54 reported that they plan to disclose HIV status to the children in the future. Conclusion: This study demonstrates that diagnosis disclosure was made in only 1/5 of HIV-infected children, and that most of the caregivers were reluctant in disclosing serostatus to the child. Development of an appropriate guideline for assisting the caregivers and the children to deal with the difficult disclosure process is needed. Keywords: HIV, Children Disclosure Psychological impact J Med Assoc Thai 2005; 88(Suppl 8): S100-5 Full text. e-Journal: http://www.medassocthai.org/journal With the advancement of the treatment of human immunodeficiency virus (HIV) infection, increas- ing number of children with perinatally acquired HIV infection and acquired immunodeficiency syndrome (AIDS) are surviving into their school-age years and adolescence (1-3) . As these children are growing older, more treatment issues become clinically important, including medication adherence and prevention of transmitting virus to other people. Therefore, the childûs participation and understanding of his/her health condition is essential (4,5) . However, telling children that they have a chronic, potentially life-threatening and stigmatizing condition is not an easy task. Many caregivers and providers are reluctant to inform chil- dren about their HIV infection status (6-7) . Research and clinical reports suggest that significant number of older children do not know their full diagnosis. Studies from the United States indicate that between 25% and 45% of school-age children with HIV infection/AIDS have not been informed about their HIV diagnosis (8) . The number is higher, with up to 83% in the United King- dom and other European countries (1,9) . Common reasons given by caregivers for not disclosing HIV infection status to their children include concerns about the negative psychological impact on the child, fears