Should there be a disclosure mandate for physicians caring for perinatally infected adolescents who don't know their HIV serostatus?

Abstract

With advances in antiretroviral therapies, perinatally infected children are now living with HIV well beyond adolescence. Parents and health care practitioners thus face the challenge of deciding how best to disclose positive serostatus to children living with HIV. Although many adolescents living with HIV are sexually active, parents often delay disclosure, which presents US physicians with an ethical dilemma because there is no legal requirement to follow clinical guidelines recommending disclosure prior to adolescence. When they become adults, US adolescents could face criminal penalties if they fail to disclose their positive serostatus to needle-sharing or sex partners despite there being no legal mandates to ensure that adolescents are first properly informed of their own diagnoses. We argue that there is an urgent need to bridge this gap between adolescent and adult HIV serostatus disclosure policies.