Children with HIV: an extensive review of the literature.(social and psychological aspects of caring for HIV patients)

Abstract

Pediatric Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) effect the entire family, and a broad range of family configurations are involved in caring for children that are impacted. Learning that a child is HIV-positive is a traumatic event, and disclosing this to the child, family members and significant others can be difficult. Families must also cope with a wide range of psychosocial concerns that include the stress of dealing with chronic illness, anticipatory loss, guilt about transmission to loved ones, social isolation, stigma, and discrimination. In addition to the physical trauma and psychological stigma of HIV/AID, popular belief has it that AIDS is invariably fatal. Families must be assisted by caregivers, and others in the mental health profession, to understand the developmental and psychological needs of their children. With time, family members generally overcome their own feelings of despair and provide the child with love and support. This paper discusses the issues that families confront when a child is infected with HIV. This paper also includes an overview of the adaptations that are needed when a child has HIV infection, and discusses coping strategies for problems associated with having a child with HIV. As such, an extensive bibliography ought to be helpful to college students and health instructors.

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Infection with Human Immunodeficiency Virus (HIV) is now known to be a disease that effects the entire family (Grosz & Hopkins, 1992) and causes a painful silence due to the uncertainties that accompany this diagnosis (Rigoglioso, 1994). The child with HIV is sometimes the index case of the family that leads to the identification of one or both infected parents, as well as other siblings that were previously believed to be healthy. Uninfected brothers and sisters are left to witness the deterioration and destruction of the family. Indeed, few diseases of childhood are known to target the entire family with such force (Abrams & Nicholas, 1990). An important aspect of this infection is its emotional impact on the child and family. How the family handles the day-to-day stressors, concerns, and needs greatly impact the outcome of the child (Miller, 1994; Saddler, Hillman, & Benjamin, 1993; Snowdon, Cameron, & Dunham, 1994). This paper focuses on the issues that families must face when confronted with having a child with HIV infection, and also reviews family reactions and parenting issues related to living with children with HIV, overviews coping strategies that are needed when a child has HIV infection, and discuses the ways of learning to cope with the problems associated with having a child with HIV.

Acquired Immunodeficiency Syndrome (AIDS) is not a single disease but a syndrome that may involve several pathological states, and is transmitted in various ways. This syndrome affects persons with diverse life histories and identities. HIV is the virus that leads to AIDS, which attacks and eventually destroys certain white blood cells, that are a part of the body's immune system and are needed for the body to rid itself of infections. The immune system makes antibodies to combat the HIV virus, and the presence of these antibodies are first detected, and may be measured, in the blood. The presence of these antibodies leads to a diagnosis of "HIV-positive". However, HIV-positive persons may remain healthy for a long period of time, even for many years. In the later stages of the disease comes the diagnosis of AIDS, and it occurs when so many white blood cells have been destroyed that the immune system cannot do its job well (American Psychiatric Association [APA], 2002; Abrams & Nicholas, 1990). Persons with AIDS develop opportunistic infections and malignancies from both usual and unusual organisms.

According to Gortner (1997), a child can become infected with HIV in two ways. First, children are infected due to perinatal transmission. Mothers that are HIV positive may pass the virus to their baby during pregnancy or birth, or from breast milk containing the virus. High-risk behavior is the second way by which children and adolescents contract HIV. Like adults, children can become HIV infected through contact with blood and other bodily fluids like semen, through the use of contaminated needles, and by unprotected sex (Gortner, 1997).

The Impact of HIV and AIDS on the Life Cycle