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HIV can be a tough subject for parents, guardians, and caregivers to discuss with their children. However it is important that all families educate their children about HIV. There are many reasons you may want to discuss HIV and AIDS with your children: you or a family member is living with HIV (HIV+), your child is living with HIV, or you simply want to help your child understand HIV so that he or she does not become infected.
It is important to note that there can be times when it is not appropriate or safe for women to disclose their status to their children or families. For more information about telling others you or your child is living with HIV, see our article on Disclosure and HIV.
Around the world, young people ages 15 to 24 accounted for two of every five new HIV infections in 2011. An estimated 2.1 billion adolescents and young people -- the largest group ever -- are currently living with HIV. Young women aged 15 to 24 are infected at twice the rate as young men the same age.
In the US, the Centers for Disease Control and Prevention (CDC) reports that young people ages 13 to 29 accounted for over a quarter of all new HIV infections in the US in 2010. Yet over half of young people who are infected do not know that they are living with HIV. A study conducted in 2009 showed that almost half of high school students in the United States reported having had sexual intercourse. Of these, over a third said they did not use a condom during their last sexual encounter and only about one in five has ever been tested for HIV despite recommendations for routine testing. These statistics serve as a serious reminder to parents that they cannot afford to avoid talking with their children about HIV. For more information, see The Well Project's Article on HIV Risk and Teens.
Children and teenagers find out about HIV from all sorts of places: TV, radio, friends, newspapers, magazines, and the Internet. Talking with your children about HIV is an opportunity to provide them with facts and correct any myths or incorrect information they may have picked up outside the home. It is also a chance to develop an open and honest relationship with your children.
The Facts About HIV
Many parents are uncomfortable talking to their children about HIV because they do not have the correct information themselves. Before you talk to your children about HIV, it is important for you to know the facts.
What Is HIV?
- HIV stands for "Human Immunodeficiency Virus"
- Without treatment, HIV will eventually wear down the immune system in most people to the point that they develop more serious infections
- Many people take powerful and effective combinations of medicines to fight the virus; however, there is no cure for HIV
What Is AIDS?
- AIDS stands for "Acquired Immunodeficiency Syndrome"
- AIDS is the most advanced stage of HIV infection
- Many people take powerful and effective combinations of medicines to fight the virus; however, there is no cure for AIDS
What Is the Difference Between HIV and AIDS?
Someone can be infected with HIV for many years with no signs of disease, or only mild-to-moderate symptoms
The CDC identifies someone as having AIDS if he or she is living with HIV and has one or both of these conditions:
- At least one AIDS-defining opportunistic infection (see a list of opportunistic infections in our article on AIDS Defining Conditions)
- A CD4 cell count of 200 cells or less (a normal CD4 count is about 600 to 1,500)
When people are diagnosed with HIV, they will always live with HIV. Regardless of how low their viral load may be -- even if it becomes "undetectable" -- they will never go back to being HIV-negative.
For more facts, see The Well Project's article: What Is HIV?
How Is HIV Spread?
HIV is spread through the following body fluids:
- Blood (including menstrual blood)
- Semen ("cum") and other male sexual fluids ("pre-cum")
- Vaginal fluids
- Breast milk
HIV is not spread through these body fluids:
- Saliva (spit)
The most common ways HIV is passed from one person to another are:
- Re-using and sharing needles and other drug equipment ("works") for injecting drugs (including steroids or hormones)
- Unprotected/unsafe sex (no condoms or other barrier devices)
- Mother-to-child (during pregnancy, birth, or breast-feeding)
How Can HIV Be Prevented?
One of the most important messages you can share with your children is that HIV can be prevented. HIV cannot be transmitted except when certain body fluids are exchanged. Teach your children that they can greatly reduce the risk of transmission by:
- Avoiding contact with sexual fluids by always practicing safer sex (using condoms or other barrier methods)
- Abstaining from sex unless they and their partners are both HIV-negative and in a long-term, monogamous relationship
- Not injecting drugs, or if they do, always using new, clean needles and other drug equipment
It is also important to tell children that HIV is not transmitted by casual contact such as:
- Being a friend to someone who is living with HIV
- Sharing food or drinks
- Using a shower, bath, or bed used by a person living with HIV
- Kissing (between people with no significant dental problems, such as bleeding gums or open sores)
- Sharing exercise equipment or a swimming pool
For more information, see The Well Project's Article: HIV Transmission.
Starting the Discussion
Every parent has his or her own style when talking about important subjects. Some parents choose to have a specific time when the family will sit down and discuss HIV. They may give out printed information (e.g., books, info sheets) or other resources to help children to understand the facts.
Other parents take cues from their children and their surroundings to introduce the subject of HIV. For example, they may try to bring up the discussion when their children see or hear something about HIV on TV. Ask what the children have heard and what they know about HIV. This will help you figure out what they already know and what is left for you to explain.
Note: When talking with your children about HIV, questions about death may come up. Explain death in simple terms. It is important not to explain death in terms of sleep. It may make your children worry that if they fall asleep, they will never wake up. It is also important to offer reassurance and explain that while HIV is serious, it is preventable and treatable.
Talking to Children of Different Ages
It is never too early to talk to your children about HIV. In fact, by age eight (third grade in the US), many children have already heard about it. Talking to children about HIV is not a one-time-only conversation. Children will be ready to hear different levels of information at different ages. Often their questions will let you know that they are ready to hear more about it. The more open you are to questions, the more likely your children will be to ask them, and the greater your opportunity to give them correct information and help them to make healthy choices. Talk early and talk often to make sure that your children have the right information for their age throughout their childhood.
Children up to age four are learning the basics about their bodies. They do not understand the concepts of disease, death, or sex. However, you can set the stage for future conversations by introducing them to the concept of sexuality by providing the correct names for body parts. Most importantly, however, you want to give young children the message that you are open to their questions. When they feel they can ask you anything, they will be more likely to talk to you as they get older.
Children five to eight years old are just learning about health, sickness, death, and sex. They can understand that HIV is a serious health problem that is caused by a virus, and that their chances of getting HIV are very small. You do not have to discuss sex at this age; however, you can teach children that some body fluids carry infection and should not be shared.
Children nine to 12 years old think a lot about their bodies. Many of them are entering or going through puberty. At this age children also feel a lot of peer pressure -- pressure from other children their age to try new (and possibly dangerous) things. Now is the time to tell them how HIV is spread. Since HIV is commonly spread by sexual contact, now is the time to give your children correct information about sex. Tell them about the importance of safer sex. Let them know that needle or syringe sharing for injection drug use, steroid injection, tattooing, or body piercing can put them at risk for getting HIV. Teach preteens that they have choices in life and that the decisions that they make today could affect them for the rest of their lives. You may also want to tell your children that it is okay for them to talk to an adult they trust (parent, teacher, older relative) if they feel unhappy, pressured, or bullied.
Thirteen- to 19-year-olds are often more concerned with their self-image and friendships than what their parents have to say. Many teenagers take risks and feel that "it can't happen to me." During these formative years, it is important to continue to provide your teen with accurate information about HIV and safer sex. You may wish to provide resources such as books and videos that they can view on their own. For more information, see The Well Project's article on What Parents and Providers Need to Know about HIV Risk and Teens.
Taking Care of Yourself
Talking with children about HIV can create anxiety for parents. Educate yourself and have resources on hand. You will feel more comfortable if you know the facts. Try to relax and let the conversation flow naturally. It is important to begin talking with your children at an early age, so that you all become comfortable with the subject and the words used to talk about it. You can use this opportunity to create a supporting and loving environment in which your children will feel comfortable asking questions and empowered to make healthy life choices.