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HIV individual interacting with non-HIV child
Jan 13, 2002

My three and a half year old son loves playing and jumping on and climbing over his uncle (my brother-in-law) whenever he visits. However, his uncle has been diagnosed with HIV recently (probably exposed around July time). My wife and I want to let the close relationship that the two of them have, to continue exactly as before. But, not knowing enough about HIV, we also want to know what to do to ensure that both of them are safe from each other. So ...

1. Where should we begin to read and educate ourselves about HIV and precautions that my son and his uncle should take?

2. My son has had very bad chronic sinusitis for about 4 months and is only just getting over it. And he is likely to get it again soon, as he is prone to it. Is he likely to be a risk to his uncle? I.e., expose his uncle to infections picked up from school, etc. that have the potential for serious danger since his uncle's immune system is becoming compromised?

3. At his present stage of development, my son is biting my wife and I and anybody he gets very familiar with. I know that the probability is low that he would acquire AIDS in this manner, but should we actively prohibit this biting behavior with regard to his uncle (as opposed to the gentler curbing we are trying to do with regard to us)?

Thanks for your guidance.

Response from Dr. Feinberg

You and your wife are to be congratulated on your level-headed approach. Here is some information that will hopefully improve your level of comfort:

1. Sinusitis isn't contagious-- your son can't give it to his uncle, or anyone else, for thst matter. Most routine childhood illnesses are not a big risk to adults with HIV, so there is little to fear with regard to your son bringing something home from contact with other children. The one exception is chicken pox, if your brother-in'law has never had it. He should ask his HIV doctor (and if he doesn't have one, he should find one right away) to do a blood test for past infection with the virus that causes chicken pox and shingles (the test is called a "VZV IgG") if there is no clear history of his having had chicken pox when he was young. If he is VZV IgG-, then he should avoid all contact with your son if he plays with or goes to daycare or school with anyone who has chicken pox. Even if your brother-in-law is VZV-negative and does get exposed to chicken pox by acident, he can be given VZ immune globulin to prevent his getting checken pox now. That's about the worst-case scenario I can think of.

2. Biting is a behavior that should not be tolerated regardless of who may get bitten. While the probability is low, You would do best to actively discourage your son from continuing to bite anyone, including his uncle. Biting is a common pediatric problem, so I suggest that you discuss ways of dealing with this with your pediatrician (which I am not).

3. You can begin learning about HIV at this web site, and there are links to many more. There is a wealth of information available from reputable websites. You can check US Public Health Service websites if you are unsure about the reliability of something you find on the web, as the US PHS is unlikely to provide links to crackpot sites. There is also plenty of information in written form. I encourage you to share your enthusiasm about learning the facts about HIV with your brother-in-law-- the more informed all of you are, the better.

Good luck to all of you!

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