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I read this article yesterday about 3 children being kicked out of school due to concerns that they may be HIV positive.

My first reaction was outrage. These poor children! How could they be kicked out of school and ostracized for a disease that isn’t their fault and that is going to affect them for the rest of their lives?! It’s horrible.

But then I thought about how I’d feel if I were a parent of one of the other children in the school, about how I’d feel if there was an HIV positive child at the school that we didn’t know about and were unable to protect our children from. No,  I don’t mean avoid the child — I mean be aware. As a parent, a teacher, or even another child you do not automatically assume a person’s blood could be dangerous. If the child falls you, or your child, may go and help, and then who knows what might happen. Thinking as a potential parent in that situation put me in a somewhat prejudiced mindset that I wasn’t comfortable with so I want to think out the options here.

I spoke with my boyfriend about this, and his first response was that the parents should tell the school and the other parents for safety and that there should be no restrictions on the HIV positive student in school so long as everyone involved is aware of their status. I asked about prejudice and the child being ostracized. He claimed it was different: “we know a child didn’t get it through a “bad” way, so there shouldn’t be a prejudice”.

Personally, I don’t think this approach is realistic. There is a stigma against HIV, even if it is caught though a non-stigmatized way (by this I mean not through injection drug use, or even unsafe sex). If people says they have HIV there are automatic assumptions made about them. Not only this, but even if the person were a child who obviously assumed no fault in catching it (please note that I am not suggesting that anyone who has HIV is to blame for catching it) they will still be treated differently. If you knew your child’s playmate was HIV positive can you honestly say you’d be just as comfortable as if the playmate were not positive?

I think the risk to the child, the psychological and even potential physical bullying of having everyone know would be extreme. They would be treated differently even if people tried not to do so. As an example, do you know anyone who has had or have you had cancer? How did people change their behavior once they knew the person had cancer? We try not to treat people differently, but we can’t seem to help it.

Imagine if everywhere you went you had to tell everyone around you some big health problem you had that was deeply stigmatizing: drug addiction, schizophrenia, even depression. Imagine that whenever you went to a new school or a new job you had to say “I am a drug addict. I’ve been clean for X years, but I used to abuse drugs”. Or any number of things. Everything would be so much more difficult. People would not want to interact with you because of it, people would be abusive because of it, and people would make assumptions about what you can and can’t do because of it. Now imagine you’re 10 and all of this is happening to you. Do you want to put a kid through that? A kid who had no say in whether or not s/he had this deeply stigmatizing disease, a kid who probably doesn’t fully understand what it means yet, a kid who will be taking medications for the rest of their life to help stay alive. Do you want to add this burden to them?

Obviously, this one child is not the only concern. What about the other kids, and the teachers and even the other parents? You could catch HIV from this child, and kids play, kids have accidents and hurt themselves. An unknowing teacher could come rushing over and help and wind up getting sick themselves. But is that totally true?

How can you transmit HIV? Blood, semen, vaginal fluid, and breast milk.

Of these, only blood is likely to be a possible exposure route for this child to transmit the disease.

So, how can HIV enter the body? Genitals, mouth with sores, needles, open wounds on skin.

Okay, so I am assuming the only interaction this child blood could have with someone else is with their skin. So, there is a chance the child could cut themselves open and then another child, teacher, or parent would come to their aid and happen to have a large sore into which the child’s blood enters. I feel like I’m already in an area of low probability here.

So, what is the probability of infected blood entering an open wound and giving that person HIV? According to the CDC “The average risk of HIV infection after a needlestick or cut exposure to HlV-infected blood is 0.3%”. Those are low odds, and those odds include needlestick exposure as well as just blood to wound exposure. The odds of just blood to wound exposure are probably lower.

So what does this mean? In my head the pros of not telling anyone the child was HIV positive far outweigh the cons (and in my mind the only real con is potential risk to others). Statistically speaking the risks to the HIV positive child are far higher than the risks to others, especially if the child has awareness of their disease and how to take precautions. This is also protected health information, we don’t expect adults to disclose their HIV status (aside from in sexual relationships, which is a whole other issue), why should we expect a child’s protected health information to be given out to whoever believes they should have it?

Honestly, I still don’t know exactly where I stand. Ideally, there would be no stigma and people would be properly educated as to how they could catch HIV. In this case, telling a school a child has HIV would be similar to telling them a child has a peanut allergy: just another medical condition.

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