When children and YP are LWHIV, it is usually considered a ‘family condition’. The parents, one or both of whom are also usually LWHIV, often experience the psychosocial burden of having transmitted the virus to their child. This commonly influences the parents’ ability and willingness to allow the young person to learn of their own HIV status. This may be further complicated if siblings living in the same household, who may not be LWHIV, are not aware. Secrecy is a common theme and the development of a therapeutic relationship with both the child/YP, and the parents/carer is essential for the nurse to guide the family through the process of sharing health information. The aim is for the YPLWHIV to learn of their HIV status without affecting their trust in their parents (8, 9, 10, 11). 

Parents commonly fear that the child/YP will unwittingly share their health information (and therefore the parents’ health information) and their concerns about disclosure should not be underestimated.   The nurse needs to support the parents while simultaneously supporting the YPLWHIV.  

As children move into adolescence, they experience changes just as their peers do, however, they are simultaneously learning about their HIV status and its impact on their lives. Activities such as school camps and sleepovers, and issues such as stigma, internalised stigma, feelings of abnormality, anxiety around romantic relationships, initiation of sexual activity and access to contraception are some complex challenges the nurse can support the young person through. (12) 

As the demographic and epidemiological landscape of children and YPLWHIV has changed across Australia, the nurse must also care for children who were orphaned, who were adopted from overseas or are from asylum or refugee backgrounds.  Being an orphan commonly leads to grief and a sense of loss which may also impact treatment adherence, particularly in the adolescent period (see 12, 13).