Q: We adopted our two-year-old daughter from a country that has a high rate of HIV/AIDS, and she happens to have HIV. Also, we have no information about her parents or life before adoption. We know we’ll have to tell her all of this sooner than we think, but don’t know how to verbalize this difficult information.

A: You are right that your daughter will have to know her personal history and medical information from a young age. While you don’t know specifics, you can explain likely reasons for her adoption, based on her country of origin—health needs, poverty, government policy. You might start early conversations by saying something like, “Your birth mother wasn’t able to take care of you. We don’t know the exact reasons why, but maybe because of ______ or ______. You lived in an orphanage until we adopted you. You will be in our family until you are 100 (a large, concrete number is easier for a young child to understand than “forever”). Your birth mother had a sickness called HIV/AIDS and you also have HIV, which means ______.” (I assume there are precautions she will need to follow around blood contact, sexual contact, blood contact etc.).” A good resource for more on explaining difficult details is Telling the Truth to Your Adopted or Foster Child: Making Sense of the Past, by Betsy Keefer Smalley and Jayne Schooler.

You can continue, “I don’t know anything about your birth parents. I wonder if your birth mother was as smart as you are, or if your birth father was as musical as you are. I wish I could tell your birth parents that you are alive and well and loved. What would you like to say to them?”