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AIDS Care. 2017 Mar;29(3):394-398. doi: 10.1080/09540121.2016.1248891. Epub 2016 Nov 1.

Costs and benefits of secrecy: the dilemma experienced by adolescents seropositive for HIV.

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a Universidade Federal de São Paulo - Escola Paulista de Medicina , São Paulo , Brazil.
b Centro de Referência e Treinamento DST/Aids , São Paulo , Brazil.
c Departamento de Psicologia Médica e Psiquiatria - Faculdade de Ciências Médicas , Universidade Estadual de Campinas , São Paulo , Brazil.
d HC/FMUSP- Instituto da Criança - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.
e Instituto de Infectologia Emilio Ribas , São Paulo , Brazil.
f La Source, School of Nursing , University of Applied Sciences , Lausanne , Switzerland.
g Faculty of Nursing , Université de Montréal , Montreal , Canada.


This study explored the experiences of the first generation of adolescents who acquired HIV through vertical transmission when disclosing their diagnosis to friends and romantic partners. The study sample was selected by convenience, with 20 patients (13-20 years old) participating in a qualitative investigation using individual interviews (language: Portuguese; duration: 45 minutes). The participants were followed in specialized clinics for the treatment of pediatric AIDS in São Paulo, Brazil. The results suggest that families who live with HIV tend to keep it a secret, and such behavior is learned and accepted unquestioningly as natural. Respect for privacy and the fear of rejection, coupled with the belief that information about their disease will be spread, are the main beliefs with which participants justify their secrecy. In terms of romantic relationships, adolescents were aware that their HIV status should at some point be shared with current or future sexual partners. However, the decision to reveal an HIV diagnosis in romantic relationships is permeated by anxieties, uncertainties about the right time, and fear of abandonment. In any case, telling the truth requires trust, guarantees of the other's love, and, in some cases, probing romantic partners beforehand to learn their perceptions about the disease. Participants who had experiences disclosing their HIV status shared positive and negative results, including emotional support, acceptance, and understanding, along with ostracism, discrimination, and abandonment by family members. The findings of this paper reinforce the challenges of revealing an HIV diagnosis to third parties. It requires understanding the meaning and importance of the secret for each patient, along with the conflict between the right to confidentiality and the responsibility of treating others exposed to the disease. All these aspects should be discussed extensively with this population and incorporated into clinical practice.


Adolescents; HIV/AIDS; partner disclosure HIV/AIDS; perinatal HIV; qualitative research

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