Self-disclosure of serostatus by youth who are HIV-positive has been considered an important objective for preventing transmission and can have positive outcomes including enhancement of social support. This paper reviews the literature on self-disclosure. Several findings are consistent with the literature in adults, including the influence of gender, lower likelihood of disclosure in casual sexual relationships, and the identified barriers of rejection and stigma. Important areas of difference include youth's expressed needs for communication skills and the significant role of the family in influencing the decision to disclose. The findings raise questions about the relationship between disclosure and safe sexual practices in adolescents and moderate the concept of universal psychological gain from disclosure. The implications from the findings are reviewed, including the individual balance of risk versus benefit, practitioner strategies that might influence this balance and enhance the likelihood of positive outcomes following disclosure, and future research directions are discussed.