Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- 43 Clinical trials for HIV-infected children
- 44 Medical issues related to the care for HIV-infected children in the home, day care, school, and community
- 45 Contact with social service agencies
- 46 Disclosure
- 47 Psychosocial factors associated with childhood bereavement and grief
- 48 Legal issues for HIV-infected children
- Appendices
- Index
- Plate section
- References
44 - Medical issues related to the care for HIV-infected children in the home, day care, school, and community
from Part VI - Medical, social, and legal issues
Published online by Cambridge University Press: 03 February 2010
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- 43 Clinical trials for HIV-infected children
- 44 Medical issues related to the care for HIV-infected children in the home, day care, school, and community
- 45 Contact with social service agencies
- 46 Disclosure
- 47 Psychosocial factors associated with childhood bereavement and grief
- 48 Legal issues for HIV-infected children
- Appendices
- Index
- Plate section
- References
Summary
Introduction
Children with HIV infection spend very little time in hospital; they live, learn, grow, and play in different settings in the community. Despite significant advances in the understanding of HIV transmission infection, a number of misconceptions continue, spawning misunderstandings that can harm children with HIV infection. In some circumstances, these misunderstandings have led to fear and the ostracism of children with HIV infection in situations which present no discernible risk to others. A major challenge for those caring for children with HIV infection is to promote an acceptance of HIV-infected children in the community. Healthcare providers bear an important responsibility to adequately educate children, their caretakers and the community at large on the risk of transmission of both HIV and other infections. Recommended practices for reducing the risk for transmission should be implemented in a balanced manner and should neither minimize nor exaggerate the relative risk for transmission. Every effort should be made to promote understanding, confidentiality, and compassion for children with HIV infection [1, 2].
Transmission of HIV
Risk for transmission of HIV is directly related to exposure to contaminated body fluids [1]. Since HIV preferentially replicates in cells expressing CD4+ and its co-receptors, transmission is highly associated with exposure to infected cells bearing the CD4 antigen (e.g. T-lymphocytes and monocytes) [3, 4]. HIV has been isolated from many body fluids (see Table 44.1), but HIV transmission is most commonly associated with exposure to body fluids, such as blood or semen, which are especially rich in lymphocytes and monocytes [1].
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- Information
- Textbook of Pediatric HIV Care , pp. 643 - 651Publisher: Cambridge University PressPrint publication year: 2005