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AIDS in Children: A Family Concern*
Charlene A. Urwin** This article assesses AIDS from a family perspective. The problem of AIDS in children and the particular needs of their families are discussed. Five categories of AIDS family concerns are proposed: emotionaland physical, social, financial, religious or spiritual, and adjustment. Suggestions are offered to help family-focused professionals workingin a varietyof settings meet these family concerns.
epidemic of Acquired Immunodeficiency Syndrome (AIDS) is most often described in populations of homosexual men, intravenous drug users, and hemophiliacs. However, increasing numbers of children are beingdiagnosed with the AIDS virus, thereby raising concerns about the children's welfare and the impacts their illnesses have on families. This recent development has created unique challenges to family educators and practitioners in understanding the difficulties of coping with AIDS, particularly for families who have young children with AIDS, and in providing information and services to addresstheir varied needs. This article discusses the problem of AIDS in children and the particular needs of their families and offers suggestions for how familyfocused professionals in a variety of settings can be helpful in meeting these family concerns. As of December 1987, 49,342 persons had been reported as having AIDS and meeting the Center for Disease Control's (CDC)definition for national reporting(there must be opportunistic infections in adults and evidence of chronic infection and failure to thrive in children). Of those reported AIDS cases, 736 were children (Center for Disease Control, 1987). Most (632)were underage 5; 104 were between 5 and 12 years of age. Although classified as adults by CDC, 201 were between 13 and 19 years of age (Center for Disease Control, 1987). Because CDC hasrigid criteria to classify AIDS cases and many cases of pediatric AIDS are mistaken for other immune disorders, some estimates project the actual number of children with AIDS to be in the thousands. The U.S. Surgeon General estimates that 3,000 children will have AIDS by 1991 (Laker,1987). Over half of all infants born with AIDS are Black, and a quarter are Hispanic (Lehman and Russell, 1987).Although some AIDS children are from
middle-class homes, most are from poorer families (Arno & Lee, 1987; NASW, 1987; Seligmann, Katz, Hutchison, & Huck, 1986). Risk factors for children include exposure to contaminated blood products, mothers who are intravenous drug abusers, and mothers with high risk sexual partners. AIDS may be transmitted from mother to child in-utero,during birth, or by breastfeeding. The majorityof these infants were infected through mothers while in-utero or during delivery (Herman, 1987). While some children do not seem sick at birth, most children develop symptoms within 6 months (Rubinstein, 1987). Almost 80% of these children (579 of a 736 total) have mothers who also have AIDS or are high risk for the disease. Many mothers do not know they...