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HIV is fragile and transmission is difficult. Numerous studies have shown that familiy members do not contract HIV/AIDS thorugh ordinary household activities such as sharing the same cup, hugging, kissing, coughing, sneezing, or spitting. It is spread through direct contact of blood, semen, or through mother to baby.
Many people don't realize that the prognosis for children on treatment for their HIV is excellent. They are expected to live long, normal lives. In fact, in the West, HIV is now considered a chronic illness rather than the terminal disease it used to be. Did you know when an HIV positive person is on treatment, the levels of HIV in the blood are brought so low that they are considered undetectable - meaning the possibility of transmission - is that much more remote? In an infant younger than 18 months of age, HIV can be reasonably excluded with two negative HIV viral tests, one at 1 month of age or older, and the other at age 4 months or older. But it is estimated that, without treatment, 50% of HIV+ children in resource-poor settings will die by the age of two.
Also, did you know that it is a legal requirement that all HIV+adopted children be added to group insurance plans without pre-existing condition clauses in all 50 states? And many states also require that private insurance plans do the same! In addition, all 50 states have funding programs that will assist with the costs of HIV treatment within specified income guidelines.
Here are websites with additional helpful information for families considering HIV kids.
www.fromhivtohome.org
www.kidswalkingkidshome.org
www.facinglife.tv/episode/season_3/episode_7/episode_307_video_full.htm
For families who may be interested in participating or HIV adopting families who need fundraising assistance
Here are some answers to frequently asked questions:
1) How is HIV transmitted?
HIV is fragile and transmission is difficult. Numerous studies have shown that family members do not contract HIV/AIDS through ordinary household activities such as sharing the same cup, hugging, kissing, coughing, sneezing or spitting.
It is spread through direct contact of blood, semen, or through mother to baby.
The rate of mother to child transmission is 20% without treatment of the mother during her pregnancy, and 10% with treatment. (lower in the US)
2) How do we test for HIV?
The most accessible and least expensive form of testing for HIV is the Antibody method. This is fairly accurate after 18 months of age. Prior to 18 months, it is accurate if it is negative. If positive, it could be a result of the antibodies acquired by the child from the mother’s HIV status. To find out if a child under 18 months has HIV, a direct method such as the DNA PCR test needs to be performed. It can be done as early as 48 hrs of age, but only 40% of people with the disease will test positive at that time. If done at 2 weeks that number changes to 93%, and by 4 weeks of age we can be pretty sure of the HIV status with a 99% sensitivity.
2) Can he/she grow out of HIV?
No, it is a lifelong disease. There are times when a child may test positive from the antibody, before aprox 18 months, and then test negative later in life due to the passing of the mother’s antibody.
2) How long will my child live?
In the US, HIV has gone from a terminal illness to a lifelong chronic illness. With current treatments, life expectancy is indefinite. There is no reason to expect a child would not have a normal lifespan if continued on proper treatment, and there is no way to see a difference in their looks or behavior after treatment. In developing countries, HIV is often left untreated and so the average life span of a child infected at birth is 2 to 3 years.
3) Will my child be able to marry and have children?
There are many examples of monogamous relationships that have not passed the virus from an infected partner to an uninfected partner. This is done with certain precautions in place. There are also techniques such as “sperm washing” that allow more certainty in childbearing.
3) How is he/she treated?
Once diagnosed, the child will need monitoring of the amount of virus in the blood (HIV viral load) and their immune system strength (CD4 count). These levels, as well as how the child is doing with other sicknesses, determines when they will be started on treatment. Once started on treatment, it is currently recommended for life without interruption.
Treatment usually consists of HAART (Highly Active Anti Retroviral Treatment). It includes 3 different types of medications active against the HIV virus that is taken in doses twice a day, every day. The most important part of this treatment is that the doses are taken completely, without missing any doses, to prevent the build up of resistance by the HIV virus to the medication.
It is usually months after being on the medications that a person’s viral load is undetectable. The implications of this are two fold. One, is that while in theory, the virus is still transmittable, it is very unlikely. Two, the person’s immune system is then as strong as it would be without HIV. Follow up CD4 counts and viral loads are performed every 3-4 months.
4) What are the side effects of the medications?
This is quite variable dependent on the type of medication used.
One of the common classes, called Protease Inhibitors, can cause a predisposition to “metabolic disorders” such as diabetes and high cholesterol later in adulthood. These things are then monitored closely, and actively prevented when possible.
5) Who should we tell?
This can be one of the most difficult parts of adopting an HIV child. It should be a matter of prayer and seeking the Lord’s wisdom.
Confidentiality laws are in place to protect parents and their children. According to the
AIDS Legal Council of Chicago, the child's pediatrician is required to notify the state Board of Health. Otherwise, disclosure is totally at the discretion of the parents.
How is this treatment paid for?
The amended ERISA Act of 1993 requires that any group health plan providing coverage for dependent children must provide benefits for an adopted child under the same terms and conditions that apply to a biological child of a plan participant. Most group insurance companies cannot exclude treatment for HIV. If you do not have access to insurance coverage, there are also state programs for children with special health care needs (CSHCS) through the local health department, as well as nationally funded programs that cover the cost of medication.
6) Where can I get more info?
http://www.adoption-link.org/chances-by-choice-program.aspx
http://adoptionadvocates.org/ethiopia/ethiopia_faqs.php
nih.gov
cdc.gov
there are also adoption blogs written by families who have adopted an HIV positive child.
