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AIDS Children Cope with  Discrimination, Shame in US Schools - 2003-11-26

Every day, thousands of children around the globe become HIV-positive; fears about contagion mean that most die as outcasts. Prevention efforts and increasingly affordable medications are allowing more HIV-positive children to survive, but their health also depends on community acceptance of the children and the need to help them.

Health expert Myles Mendoza, from the western U.S. city of Denver, Colorado, says HIV-positive kids are ostracized because of widespread fear about how the virus spreads.

"The discriminations at their school, having to hide, directly affects their medical status, being unable to take medications publicly; they miss doses, because they don't want anybody to know that they're HIV-positive."

Mr. Mendoza is a staff member at Children's Hospital of Denver, specializing in assistance and outreach to Colorado state's 1,200 HIV-positive youth, who range from infants to age 24. Government programs pay for most of the anti-retroviral medications that help them stay healthy. But these young people encounter so much revulsion about HIV, it's emotionally stressful, even when they've tried to hide their condition.

"What happens is that other people will find the medication, then they'll search it on the web, and they'll find out it's an HIV-related medication, and then the kids are 'outed' to the school, and then you've got parents that are upset," he said.

To help communities accept HIV-positive kids, Mr. Mendoza holds seminars to explain how the disease is, and is not, transmitted. Since most teens become infected through sexual experimentation and injected drugs, the kids in his program receive extensive training in responsible behavior, to reduce the chance that they'll infect other people or contract a more drug-resistant strain of HIV. Mr. Mendoza makes sure that everyone knows kissing's okay, since saliva is such an unlikely transmission route for the virus.

"Our favorite fact about saliva, that I love to give, because it usually makes the kids go crazy and scream and throw stuff at me, is, if you were to take six gallons of saliva, and inject that directly into your bloodstream… that would be a bigger problem than the actual risk of HIV," he said.

Outlining precautions that everyone should take can help a community accept infected teens, but since young children can also be HIV-positive, many parents worry that there must be a more ominous, hidden infection pathway. This leads Myles Mendoza to explain that the vast majority of babies contract the condition from an HIV-positive mother while still in the womb, during labor or from breast milk. There are now ways to prevent this mother-to-child transmission, and Jeff Safrit, with the Elizabeth Glazer Pediatrics AIDS Foundation, says that measures taken in the United States are remarkably effective.

"The results of treating pregnant woman with anti-retroviral therapy prior to giving birth has reduced the transmission rate dramatically, in this country and in European nations as well, from 15 to 30 percent if they're not treated, to less than 2 percent, which is one of the best success stories in the field of HIV in general," he said.

In the United States, only 200 babies become HIV-positive every year, and treatment is available so that most of them can grow up healthy. What's more, since the peak of the U.S. epidemic in the early 1980s, the rate of new infection at all ages has dropped by 75 percent. Unfortunately, this degree of success is only common in more prosperous nations. Globally, 2,000 infants become HIV-positive every day, and because few receive medications, most die. The pandemic is most severe in poorer nations, where HIV infects over 35 times the number of Americans who live with the condition. Many of those infected are mothers and fathers, and as they succumb to AIDS-related illnesses, children are left without parents. Mr. Safrit says that if the crisis had been striking the United States with equal force, the pandemic might be over by now.

"We'd have a [nationally organized] March of Dimes effort, because there would be parents screaming for treatment or for vaccines to protect children against this disease," he said.

Jennifer Delaney, of the Hope for African Children Initiative, compares the AIDS situation in the U.S. and in Africa. Her group is pushing hard for the United States to make good on its promise of increased funding for HIV/AIDS programs in developing nations.

"You're going to lose a whole generation of human beings. Just think what would happen in the United States if all the children in the States died now. I mean, what would happen in the U.S.? Think of that in terms of Africa and the other countries that are being hit so hard right now with the HIV-AIDS epidemic," she said.

Smallpox was a seemingly unstoppable disease that has been contained through the fortitude of many nations. Ms. Delaney says that similar determination is needed to combat HIV/AIDS.