Infection Control

All liquid waste, such as urine or vomit that has blood in it should be flushed down the toilet. Be careful not to splash liquids as they are being poured into the toilet. Paper towels, sanitary pads and tampons, wound dressings and bandages, diapers and other items that have blood on them and cannot be flushed should be placed into a plastic bag, sealed and then placed into a second plastic bag before placing in the trash.

Immunizations

Indiana currently requires that children receive many vaccinations in order to be admitted into the school system, including the measles vaccine. This vaccine is a "live" vaccine and usually given as MMR-(measles, mumps and rubella). A live vaccine actually has the germ in the shot, although it is a very weakened form of the germ that is unlikely to cause problems in a healthy individual. However, in a person with a weakened immune system, the shot may cause problems including giving the person measles. People may have the MMR if they have had a CD4 count over 1000 for a few months. Before any child with HIV receives this vaccine, the health care team should be notified to be sure it is safe. Since vaccines are given by a primary medical doctor, your doctor may need to contact the HIV team to ensure the child's safety.

Travel

Although travel to other areas, particularly to other countries or trips involving exotic activities such as scuba diving or caving can increase the risk of infections, not all travel plans have to be abandoned. With good advance planning, many trips can be made.

School

According to the current Indiana state law and in every other state, families do not have to tell the school or anyone else in the education system of their HIV status. HIV testing is not required for any purpose.

Recess and School Sports

Children with HIV can participate in recess, gym class, and sporting events. By law, the school must allow a student with HIV participation in these activities.

Safe Food and Water

Germs in food and water that can make someone with HIV sick include Salmonella, Campylobacter, Listeria, and Cryptosporidium. They can cause diarrhea, upset stomach, cramps, fever, headache, body aches, blood stream infections, meningitis or encephalitis. People with HIV may become extremely ill with these germs and may have a difficult time recovering.

Swimmimg

While it is not necessary to take all the fun out of things, it is important to know that certain activities can increase your risk of infection, especially in people with lowered CD4 counts. Swimming is an activity that may increase a person's chances for infection, especially if it is done in lakes, ponds, or the ocean.

Pets

Animals can carry infections that can be harmful to human beings. Such infections include many discussed elsewhere in this book (cryptosporidiosis, toxoplasmosis, MAC) and others such as cat scratch fever. These diseases can give you problems like severe diarrhea, brain infections, and skin lesions. When making the decision to bring a pet into your home, it is important to discuss it with the health care team before purchasing the pet. While we are not recommending that you get rid of pets you already have, we do caution against bringing new and particularly young pets into your home. If you already have a pet, please make sure it gets regular check-ups at the vet.

Nutrition

Good nutrition and maintaining body weight by taking in enough healthy calories is an important goal. A dietitian from the health care team will be scheduled to meet with you and your child in the clinic one to two times per year or more frequently if necessary. The dietitian can also be scheduled at your request any time you have questions or concerns.

Care of the Teeth and Mouth

Children with HIV have more cavities, tooth decay, and gum disease than other children - about 30% more. People with low CD4 counts cannot keep all the germs that commonly live in the mouth under control. This allows those germs to do more damage to teeth. Children who eat and drink a lot of sweets, who drink from a bottle in the crib, and those past one year of age are at even greater risk for teeth problems.

Sexuality

While it may be difficult, it is important to have serious discussions with teenagers who may be thinking about becoming sexually active. This is extremely important in HIV positive teenagers who are considering becoming sexually active.

Reproductive Healthcare

There are certain gynecological (GYN) conditions that occur more often in females that have HIV or AIDS.

Depression and Other Psychiatric Concerns

Many people will experience some periods of sadness or depression during their years growing up. This is also true of children and teenagers who are positive for HIV. Sometimes the depression may be caused from feelings of fear or isolation if other people find out that the person is HIV positive. Sometimes, fear of AIDS or dying can be a factor. People can get depressed over knowing that they may be dependent on medications or may be ill frequently for the rest of their lives. Some medications can cause depression or other psychological issues as well. These feelings are natural and must be addressed. Parents may also experience depression over their child being perceived as ill or some guilt they may feel over the child being infected.

Disclosure

Disclosure or telling people that you or your child are HIV positive is very difficult. Even telling a child who was infected at birth that they are HIV positive can be very hard on both the parent and the child.