Disclosure of maternal HIV-infection in South Africa: description and relationship to child functioning.

South Africa has one of the highest HIV-infection rates in the world, yet few studies have examined disclosure of maternal HIV status and its influence on children. This study provides descriptive information about HIV disclosure among South African mothers and explores whether family context variables interact with maternal HIV disclosure to affect children's functioning. A total of 103 mothers, who self-identified as living with HIV and who were the primary caregivers of a child between the ages of 11 and 16, were interviewed. A total of 44% of mothers had disclosed, and those who had most typically perceived children's reactions to disclosure to be sadness and worry. Widows and married mothers were more likely than single mothers to disclose their HIV status. Disclosure to children significantly predicted externalizing, but not internalizing, behaviors. Family variables had direct but not interactive effects on child functioning. This study highlights the complexity of disclosure-related decisions and the importance of addressing the family context.