The changes noted above also need to be explained to the young person. Greater emphasis should be given to providing opportunities for the young person to take more of a lead in consultations with the doctor as they approach adolescence. In time they should be offered the choice of part of the health consultation to be by themselves.

Once the young person knows their diagnosis of HIV then discussions around HIV issues can also begin. Some of these will be with parents in the consultation and as time goes by without parents too. Issues of privacy and confidentiality will need to be given particular consideration during this time.

At this point many young people appreciate doctors’ letters being copied to them, and specific letters with results following clinic appointments being sent directly to them.

If this process is working well then both parents and the young person should feel that they can discuss freely all aspects of their care.