Talking With Children About HIV/AIDS

Lynn B. Pike
Department of Human Development and Family Studies

What adults must know

Acquired Immunodeficiency Syndrome (AIDS) is the third leading cause of death in Missouri for people 25 to 44 years of age. Through June 1994, more than 5,000 Missouri citizens had contracted AIDS, and about half of them had died. In addition, many of those diagnosed between the ages of 20 and 29 probably were infected as teenagers. Approximately 4 percent of all those with the Human Immunodeficiency Virus (HIV) in Missouri were diagnosed when they were teenagers. This is the virus that causes AIDS.

As these statistics show, AIDS is a serious illness and a public health crisis that demands attention.

AIDS is a disease we can prevent. It is extremely important for parents, teachers, clergy and other adults in contact with youth to provide honest, accurate information. One of the fastest growing populations of HIV-positive and AIDS victims are teens and young adults. Although some young people are abstaining from sexual activity, many are sexually active. These young people need the facts about AIDS.

AIDS is the life-threatening disease caused by HIV. The virus depresses the body's immune system, making it difficult for the body to resist bacteria and viruses that might cause disease. The infected person is at high risk for diseases such as lung infection, pneumonia and cancer. Once developed, the full-blown syndrome results in death.

Knowing the facts about AIDS is necessary for individuals to choose healthy behaviors and attitudes. The facts are:

Anyone can get HIV. Anyone, regardless of sexual orientation, who engages in high-risk behavior with an infected person is likely to get the virus.
You will not get HIV through everyday contact with people at work, at school, at the swimming pool or in other casual situations.
HIV is not passed in saliva, sweat, urine, bowel movements, tears, mosquito bites, clothes, phone receivers or toilet seats. It is not passed by donating blood, eating in restaurants or shaking hands.
The virus is passed in semen, vaginal fluids and blood. It can enter the body through the vagina, penis, rectum, mouth or any cut or open sore. Anal intercourse is especially risky due to the delicate tissue involved. The virus can be transmitted by exchange of semen or secretions during intercourse, from mother to fetus during pregnancy or birth or by sharing needles or syringes with drug users.
Abstinence is the only 100-percent safe choice to avoid sexually transmitted AIDS. Condoms are the best defense against the sexual transmission of HIV, but they are not foolproof. Latex condoms provide the best protection, but any condom must be used properly and every time.
AIDS is fatal.

High-risk behavior

Sex with someone who has had several sex partners or who will not openly discuss past sexual experiences.
Unprotected sex (without a condom) with an infected person.
Sex with someone who injects drugs.
Sharing drug needles and syringes.

Safe behavior

Not having sex (abstaining).
Not injecting drugs.
Sex with only one mutually faithful, uninfected partner.

Children at different developmental stages handle AIDS information differently. You are the best judge of what to say and how much they can understand.

Ages 5 to 7

Although children 5 and under have a difficult time understanding the difference between real and imaginary, children 5 to 7 are beginning to separate the two. They learn best from experience. When confronted with a topic they do not know about or have not experienced, they may respond by being fearful.

Children 5 to 7 have many fears, and the best way to help your child is to provide reassurance and ask him or her to talk about the fears. With AIDS receiving so much attention, it is possible your child is asking questions or is too afraid to ask questions. A child 5 to 7 is probably not ready for all the details, but a simple explanation is important. An example might be:

AIDS is a sickness caused by a specific kind of germ called a virus. The virus is carried in some people's blood. You can't get AIDS from touching someone or being around a person with AIDS like you can catch a cold from a friend. You can't get AIDS from being in the same school as someone with AIDS. You can't get it from pets, flowers, mosquitoes, toilet seats, water glasses or hugs.
You may have heard that some children have AIDS. Some children may have been born with it because their mothers had it. Now there are tests so people with AIDS can try to avoid giving it to anyone else.
If you ever have questions or are afraid of anything else, please ask me. It helps to talk about fears to find out if they are real or imaginary. If your fears are real, it helps to learn what we can do to make concerns likes AIDS less scary.
You are healthy, and I am going to help you stay healthy by teaching you to make smart choices.

Your children may ask questions you cannot answer. That is OK. AIDS is a topic with many unanswered questions, even though we know much more now than we did a few years ago. Don't be afraid to say you are not sure about an answer, but explain you will find out. The Red Cross is a good place to start for accurate information. Other sources of information are listed at the end of this publication.

Ages 8 to 10

Between ages 8 and 10, children's fears change. They used to be afraid of monsters and other imaginary characters. Now they are more likely to be afraid that a real person might hurt them.

At this age, they are beginning to understand cause and effect. For example, climbing in a tree might result in an injury. Most children 8 to 10 know death comes from an injury, illness or accident. Although their understanding may increase, their fear does not necessarily decrease. They may talk about fears less openly now, so it is important for an adult to look for an opportunity to bring up topics that might be bothering them.

Hardly any child 8 to 10 has not heard about AIDS. The media attention puts parents in an awkward situation where there is a need to discuss AIDS but a basic discussion about sex may be needed first. The media emphasis on AIDS might increase your child's fear level but also provide "teachable moments." Children need to be encouraged to talk about their feelings.

An example of what you could share with your child about AIDS is:

AIDS is a sickness you can get from a certain virus. AIDS stands for Acquired Immunodeficiency Syndrome. That is a fancy way of saying the army of cells that fight sicknesses is not working. The virus destroys the cells needed to defend a person from illness, so the person gets very sick.
When people find out this virus is in their bodies, they are said to be "HIV positive." Eventually, the virus will turn into the full disease, called AIDS.
People are worried about AIDS because there is no cure for it. You cannot get a shot to prevent it as you can for measles. People who get AIDS eventually die.
You can get HIV from the blood of an infected person (such as through the birth of a baby or cuts and open sores), by sharing a needle for shooting drugs and from sexual intercourse.
You cannot get HIV from urine, feces, mosquitoes or pets. You also can't get it from hugging, eating from the same plate or drinking from the same glass as an infected person or being in school with an infected person.
Today we know that HIV can be passed in any sexual relationship. When people have sex with people they do not know, they are more likely to get the virus.

It is important to make time to talk with children at this age. This is the age values are learned. If you wait until high school, it is often too late.

Good information taught in a secure environment such as the family is the best protection you can give your children as they go out into the world. Tell them you love them and want them to share their thoughts and feelings with you.

Ages 11 to 14

This age group varies in maturity. You are the best judge of how much to say about sexuality and AIDS, but do not avoid the topic because you have already talked about it once or because you gave your child a book to read. Pre-teens and teens need to hear your messages often. The ironic situation is that most teen-agers have very little fear. In fact, they have entered the age where they usually believe, "It will never happen to me."

The following information is an example of what can be shared with this age group:

AIDS stands for Acquired Immunodeficiency Syndrome. AIDS cripples the body's normal ability to fight invading germs and infections. AIDS refers to a whole set of infections and tumors that can't occur if the immune cells of the body are OK. The Human Immunodeficiency Virus (HIV) is the virus that causes AIDS, and it destroys these disease-fighting cells. A lot of other viruses and germs then can attack someone who has HIV. There is no vaccine or cure. AIDS is fatal.
You can get HIV by being involved in high-risk behaviors such as sexual intercourse with an infected person. The virus is carried in semen and vaginal fluids. These fluids come out during sex and are passed to the other person. You cannot destroy the virus by washing after sex. You can wear a condom during sex. However, condoms have been shown to be about 98 percent effective in preventing HIV. The only sure way to reduce your chance of getting AIDS to avoid having sex -- abstaining.
You also can get HIV by sharing needles for shooting drugs because it's carried in the blood left in the needles. Newborn babies can get the virus from their moms. It is rare to get it from blood transfusions because blood is now screened for the virus.
You can't get HIV from being in casual contact with an infected person, hugging, sitting next to an infected person, using plates or glasses of an infected person, drinking from a water fountain, being coughed on, or swimming or wrestling with an infected person.

Ages 15 to 18

Parents and concerned adults often worry about the sexual decisions of 15- to 18-year-olds. It is important to explain that anyone can be infected by AIDS, regardless of sexual orientation.

Fifteen- to 18-year-olds may be under pressure to be sexually active because of things they see or read in the media. They also are influenced by peers, the individual with whom they are involved and their own hormones or curiosity. One of the best prevention tools is your open and honest communication. In addition to the information appropriate for teen-agers aged 11 to 14, these comments may be helpful to older teens:

The best way to avoid getting HIV is to avoid intercourse. I prefer that you have no sex before marriage because you would be safest if you did not have sex until you found the person you plan to marry and you are confident of his or her past. I want you to enjoy sex in a loving relationship, and I do not want you to take chances that can expose you to HIV or an unwanted pregnancy.
When you care about someone, you may feel a lot of pressure to do what he or she wants you to do. But think about it -- if someone really cares, would that person want you to risk your future? Or, is that person only interested in meeting his or her own needs? It is hard to say no, but it is harder to deal with pregnancy or disease.
One problem with intercourse at an early age is that rarely do you end up marrying this person you said yes to. The more partners you are exposed to early, the more likely you are to contract a sexually transmitted disease (STD) such as AIDS. The effect is as if you are having sex not just with one person but with all the people that person ever had sex with.
It is your responsibility to abstain from sex or to ask sensitive but important questions about your partner's past sex and drug experiences. If you know someone well enough to have sex, you should be able to talk about AIDS. If someone is unwilling to talk, you should not have sex.
If you do decide to become sexually active, condoms used with a spermicide can reduce the risk, but are not 100-percent effective.
The best way to avoid HIV and AIDS is to refrain from the high-risk factors. You are getting older, but you are not old enough to have all the answers. Neither am I. I hope you will be able to talk to me if you have questions. I will always love you no matter what, and I want you to make healthy decisions now so your future will be healthy, too.

For more information

National AIDS Hotline (Centers for Disease Control)
800-342-AIDS.
Missouri Department of Health, Jefferson City
573-751-6438.
AIDS Project of the Ozarks, Springfield
417-864-4494.
Good Samaritan Project, Kansas City
816-561-8784
800-234-TEEN (hotline).
Missouri HIV/AIDS Education Network, St. Louis
314-658-2019 or
800-245-2559.
Local MU Extension center, check local telephone book under Government Offices-County.

References

Missouri Department of Health, (June 30, 1994). The Epidemiology of HIV/AIDS in Missouri, Summary.
Gebeke D. (1991). Talking to Kids About AIDS. Fargo, ND: North Dakota State MU Extension Service.

Elementary school

Sanford, D. (1989). In Our Neighborhood: David has AIDS. Portland, OR: Multnomah.
Hausherr, R. (1989). Children and the AIDS Virus: A Book for Children, Parents and Teachers. New York: Clarion Books.
Fassler, D., and McQueen, K. (1990). What's a Virus, Anyway? The Kids' Book About AIDS. Burlington, VT: The Waterfront Press.
Girard, L.W. (1991). Alex, the Kid with AIDS. Morton Grove, IL: Albert Whitman and Co.

Middle school/junior high

Arrick, F. (1992). What You Don't Know Can Kill You. New York: Bantam Books.
Schwartz, L. (1993). AIDS Questions and Answers for Kids: Grades 5-6. Santa Barbara: The Learning Works.
Jordan, M. (1989). Losing Uncle Tom. Morton Grove, IL: Albert Whitman and Co.
Wiener, L.S. (1994). Be a Friend, Children Who Live with HIV Speak. Morton Grove, IL: Albert Whitman and Co.

High school

Bess, C. (1993). The Mayday Rampage. Sacramento, CA: Lookout Press.
Blake, J. (1990). Risky Times: How to be AIDS-Smart and Stay Healthy, A guide for teen-agers. New York: Workman Publishing (also includes parents' guide).
Ford, M.T. (1993). 100 Questions and Answers about AIDS. New York: The Beech Tree Paperback Book.
Schwartz, L. (1993). AIDS Questions and Answers for Kids: Grades 7-12. Santa Barbara: The Learning Works.

Professional books

Cox, F.D. (1994). The AIDS Booklet, third edition Madison, WI: Wm. C. Brown Communications.
DiClemente, R.J. (1992). Adolescents and AIDS: A Generation in Jeopardy. Newbury Park, CA: Sage.
Geballe, S., Gruendel, J., and Andiman, W. (Eds.) (1995). Forgotten Children of the AIDS Epidemic. New Haven, CT: Yale University Press.
Griggs, J. (1989). Simple Acts of Kindness: Volunteering in the Age of AIDS. New York: United Hospital Fund of New York.
Henggeler, S.W., Melton, G.B., and Rodrigue, J.R. (1992). Pediatric and Adolescent AIDS. Newbury Park, CA: Sage.
Huber, J.T. (Ed.) (1992). How to Find Information About AIDS. New York: Harrington Park Press.
Landau-Stanton, J., and Clements, C.D. (1993). AIDS, Health, and Mental Health. New York: Brunner/Mazel.
Levine, C. (Ed.) (1993). A Death in the Family: Orphans of the HIV Epidemic. New York: United Hospital Fund of New York.
Miller, H.G., Turner, C.F., and Moses, L. (Ed.) (1990). AIDS: The Second Decade. Washington, DC: National Research Council.
Quackenbush, M. (1992). Does AIDS Hurt? Educating Young Children About AIDS, second edition. Santa Cruz: CA: ETR Associates.
Ulack, R., and Skinner, W.F. (1991). AIDS and the Social Sciences. Lexington, KY: University of Kentucky Press.

GH6000, reviewed July 1997