August 14, 2012
Children born with HIV who are coming of age face unique challenges: drug resistance, access to care, stigma, uncertainty about when to disclose their status to a partner, and concern about the virus' long-term effects on their bodies.
Dr. Laura Hoyt, a pediatric specialist at Children's Hospital in Minneapolis, said the risk of developing drug resistance is higher in kids who are born HIV-positive because they typically have been taking medications much longer than people diagnosed with HIV as adults. But according to Dr. Lynne Mofenson, chief of the Pediatric, Adolescent, and Maternal AIDS Branch at the National Institutes of Health, few studies have examined the long-term effects of HIV and the drugs used to treat it.
Young women born with HIV must also carefully consider starting a family. Medical breakthroughs in treatment have lowered the risk of perinatal transmission from 25 percent to around 2 percent. But if a mom has detectable virus amounts at the time of delivery, a natural birth may not be possible since the contracting uterus can pump HIV-infected cells into the baby's circulatory system. And babies passing through the birth canal can swallow infectious genital fluids, increasing the chance for transmission.
Ashley, 22, who asked that her last name not be published, learned she was HIV-positive after spending weeks at Children's around her 14th birthday; she had acquired the virus from her mother. The diagnosis "shattered my dream of a fairy-tale life," she said. For many years, she thought no one would love her or want a family with her. However, Ashley has persisted and is an honors student at a local community college and an active member of her church, with plans to have a family one day.