Children and HIV

Challenging Behavior in Elementary and Middle School

Selected Work by Judy Sklar Rasminsky

Children and HIV

Co-author Barbara Kaiser
Chatelaine, October 1994
500 words

Parents of children at a Montreal daycare center last winter were dismayed to learn that a 2-year-old girl had the human immunodeficiency virus (HIV), which can lead to AIDS. They sympathized with Jessica Dos Santos and her need for friends and loving care, but their concern for their own kids� health was so overwhelming that they voted to exclude her from the center.

Montreal pediatrician Nancy Haley, who has worked with children with AIDS for ten years, understands that it�s natural for parents to worry, but she says the risk of child-to-child transmission of HIV, inside or outside of daycare, is infinitesimal. Roughly 80 to 150 children are among the estimated 30,000 Canadians with HIV or AIDS. However, there are no known cases of transmission through casual contact.

HIV can spread through unprotected sex and the sharing of contaminated needles, and from an infected woman to her baby during pregnancy or delivery. Transmission through blood or body fluids that contain blood is possible if there is a route of entry into the uninfected person�s bloodstream�e.g., through a blood transfusion or a deep wound.

Two cases of child-to-child transmission were reported in the United States, but Dr. Haley says they occurred under highly unusual and unhygienic circumstances�between hemophiliac brothers who shared razors, and between two children who had oozing infections and sores and slept in the same bed.

According to Dr. Haley, there�s no danger if blood from an infected child's nosebleed or cut splashes onto another child�s intact skin. If an infected child bit another child, Dr. Haley says the virus could be transmitted if the bite was deep enough to break the skin and cause bleeding (uncommon with preschoolers� bites) and the infected child had his own blood in his mouth. If an uninfected child bit an infected one, enzymes in saliva and gastric secretions would act to protect against the virus, and she would be at risk only if she had wounds inside her mouth and drew blood from the HIV-positive child. Dr. Haley says there have been no confirmed reports of transmission through kids� biting.

According to Dr. Haley, HIV is not transmissible through:

urine or stool, diapers or toilet seats;
saliva, mucus, or sweat;
stools and vomit untainted by blood;
touching, hugging, kissing, coughing, or sneezing;
the sharing of food, utensils, drinking glasses, dishes or toys, even if kids put toys in their mouths.

Dr. Haley advises parents and caregivers:

After contact with all bodily fluids, wash hands with soap and water for at least 15 seconds.
Don't let kids share toothbrushes.
Remove broken toys and ensure children's scissors have rounded edges. Teach children not to touch syringes and other sharp objects.
Cover wounds with a dressing.
Teach children to wash their own cuts, hold the tissue to control their own bleeding, and call an adult when someone else is bleeding.
Use tissues or paper towels to stop bleeding. Wear disposable latex gloves if there is a lot of blood or other bodily fluids or you have open cuts or sores on your hands. Wash hands after removing gloves.
Immediately clean up blood spills and disinfect the area with a fresh solution of one part bleach and nine parts water.
If a child�s open wound comes into contact with another child�s fresh blood, gently bleed the wound, wash with soap and water for 15 to 30 seconds, and call your doctor for advice.

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