HIV. It used to be a scary, devastating diagnosis. Things have changed for the better in the past 10 years, and new research is still going on. I want to answer some questions that I have been asked. This was sparked by the recent article on the No Hands But Ours Blog. A dad of HIV positive adopted twins wrote a great post. Here is the link: http://www.nohandsbutours.com/2014/03/19/six-pills-a-day-a-cure-for-my-ignorance-regarding-hiv/
First let's re-cover the basics. HIV is a virus that attacks the body's CD4 cells. The CD4 cells help with immunity and fighting off infections. HIV lowers the number of CD4 cells-which is why the CD4 count is one of the labs monitored. If the CD4 count is too low, a person with HIV can catch other infections easier. It is these infections that actually caused so many with HIV/Aids to die. The difference between HIV and Aids is the CD4 count. In people without HIV or people with well-managed HIV the CD4 count range is 500 to 1600. AiDS is diagnosed when that level drops below 200.
Now HIV is also monitored by viral load. The actual number of HIV viruses are counted in a sample of blood. The viral load can be very high - in the hundreds of thousands or what is considered "undetectable." Undetectable is the goal of HIV treatment. Undetectable means that there are so few viruses present that they cannot be counted. Usually this is less than 50-70 viruses present. Having an undetectable viral load means there is less chance of catching an infection. Having an undetectable viral load also means it is basically impossible to give it to someone else.
I gathered some interesting statistics about HIV. There are about 3.2 million kids living with HIV worldwide (under age 15). 700 are newly infected daily. HIV is NOT present in urine, feces, snot, saliva, sweat, tears, or vomit unless there is also blood present.
There has NEVER been a case of accidental transmission in a normal household setting.
So let's get to the questions people have about HIV. I will answer these questions in this post, and I will work on a part 2 post- so please let me know of other questions that come up. What other info would you like to know?
1. If my kid who has an open cut, is playing with a friend that has HIV who gets hurt and bleeds, should I worry? Well basically- no. Most kids with HIV here in the US are under treatment and have undetectable viral loads. HIV also cannot live outside of the body. When it hits air it dies. So the chance of a live virus getting into the HIV negative kiddo's open cut is very low. There has NEVER been a case of the virus spreading this way.
2. Can HIV be spread by casual contact? Nope! HIV is only spread in 3 ways. Sex with a partner with a high Viral load, sharing needles, and mother to child during childbirth and/or breast feeding. And there are actually ways a person could do all three activities without spreading the virus!! Now those people who know that they will be or were recently exposed to a HIV positive person with a high viral load can take the antiviral meds to prevent the negative person from catching it. I actually deal with this a lot. I work in employee health at a hospital, and we treat needle stick injuries. When the source's HIV status is not known, we give antiviral meds to the employee. Not one has ever caught HIV if they take the meds. These meds are also given to newborns if their mom is HIV positive. So if you have a HIV positive daughter, she can give birth and her kiddo will be HIV negative if given the meds. She cannot breast feed though. (Well at least not now- new research is always being done).
3. If my kid has HIV who do I have to tell? No one. Of course you will want to tell your docs and dentist. There is no obligation to tell family, friends, the school, church, etc.
4. What do I do if a HIV positive kiddo gets hurt while under my care? The same you would for your own kid. Clean up the blood (using gloves or some sort of barrier- like some paper towels) and apply band aids and kisses.
5. Can people stop responding to the meds? Are they expensive? It is possible but there are choices in the meds. Working closely with the doc decreases this possibility. The meds can be expensive but there are many pharmaceutical companies or government programs that help with cost and insurance pays part. Many pay between 35 and 150 dollars per month for the meds.
6. How is HIV treatment different in China? They use the same meds and usually the kiddos are on meds and have very low viral loads when they are adopted. Not everyone in China has access to meds, just like the access to general medical care is limited. There is a huge stigma in China- it is falsely believed that HIV can be spread through casual contact. If a person is found to be HIV positive they basically are shunned. It is very sad. My favorite charity works with HIV there and recently posted a story of a boy who was put on isolation in the hospital because of a nosebleed. There are organizations working hard to educate in China.
7.Can a kiddo with HIV get married and have biological kids? Yep!!! In a study of 1140 couples where one partner had HIV with a viral load of less than 200 and the other did not have HIV there were NO cases of transmission. None. Here is a chart summarizing the findings. Source:
Www.thestigmaproject.org
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