The decision to tell a child or young person about HIV will often be determined by the age of the child and by their understanding of a number of concepts (such as the functions of the body or the nature of illness). The best person to do this is the parent. If this is not possible, it should be someone who has a close relationship with the child or young person. It is helpful to the child or young person if the parent is prepared to create an open environment where the child or young person can ask questions or express their reactions to being told.

A child or young person may notice differences in their home, and be asking questions such as 'why are more people coming into the house?', or 'why are you always ill and having to go to hospital so often?' Sometimes the child or young person may not be able to verbalise their perceptions about changes in the household. They may be exhibiting signs of their distress through their behaviour, such as having nightmares, being clingy or lacking concentration. Parents may decide, as a result of these situations that their child should be informed that a family member has HIV.

In many families, the process of telling a child or young person about HIV occurs over a period of time. A parent may begin this process by talking about HIV in general so the child/young person gains a basic awareness of HIV.

Media attention or education through schools on HIV may prompt children to make comments or ask questions about HIV. Parents may answer these questions as they arise as preparation for the time the child or young person will be told about a family member having HIV.

The continuation of this process will be informing the child or young person that a member of their family has HIV. Parents hope this two-stage process will decrease the likelihood of a negative response from the child or young person, who should have a more accurate and sympathetic view of HIV than is usually portrayed in the media. Parents also hope that by giving the child information in small parts, s/he has less to understand when they are told about a family member having HIV.

It is a crucial to consider the timing when parents decide to tell their children about HIV. Parents may find it easier to tell their children about HIV in the family when they feel emotionally strong enough to cope with any possible reactions their children may have.

Parents often judge the 'right time' to be when they feel their child is emotionally strong enough to be told or when they are less likely to be distracted, for example during school holidays or after examinations. This consideration about timing enables the parents to explain what they want to say to the child or young person as fully as possible. The child or young person may want to ask questions or may need time to express their immediate feeling without worrying about interruptions.