PEDIATRICS Vol. 100 No. 1 July 1997,
p. e8
Copyright ©1997 by the American Academy of Pediatrics
ELECTRONIC ARTICLE:
School-related Issues Among HIV-Infected Children
Received Nov 7, 1996; accepted Jan 22, 1997.
,
,
From the * Massachusetts Department of Public Health, Jamaica
Plain, Massachusetts; the Children's Hospital, Boston,
Massachusetts; the § Boston City Hospital, Boston, Massachusetts; the
¶ Greater Lawrence Family Health Center, Lawrence, Massachusetts; the
Baystate Medical Center, Springfield, Massachusetts; the # University
of Massachusetts Medical Center, Worcester, Massachusetts; and the
** Division of HIV/AIDS Prevention, Centers for Disease Control and
Prevention, Atlanta, Georgia.
Objective. Many children with human immunodeficiency virus (HIV) infection are surviving long enough to reach school age. This study describes issues related to school attendance and disclosure of HIV infection in a population of HIV-infected children.
Methods. A statewide pediatric HIV surveillance system was
used to collect data on school-age (
5 years old) HIV-infected children. In addition, HIV clinic nurses familiar with the child's history participated in a cross-sectional survey that collected information on school-related issues during the 1993-1994 school year.
Results. Of the 92 school-age children, only 3 were too ill to attend school. Another 5 children were home-schooled. Of the 84 who attended school outside the home, 25% had severe symptoms of HIV infection (Centers for Disease Control and Prevention [CDC] clinical category C). Absence from school ranged from less than 2 weeks during the year for half of the children (51%) to more than 8 weeks for 9 children (12%). Twenty-nine percent of the children received medication in school, usually administered by the school nurse. Over two thirds of the 50 children ages 5 to 10 years had not been told that they had HIV infection. Only 1 of the 20 children more than 10 years of age was not aware of her HIV infection. For 53% of the children attending school, no school personnel had been informed of the child's HIV infection. Administration of HIV medications at school, age of child, and treatment at one particular HIV clinic were associated with the parents' decision to inform school personnel. In the 47% of cases where the school had been informed, school nurses were most frequently notified, followed by principals and teachers.
Conclusion. Only 3% of school-age children were too ill to attend school, and almost all were enrolled in public schools. The number of HIV-infected children reaching school age will continue to grow, and public schools will bear the responsibility for educating these children. Health care providers will increasingly be called upon for guidance by both educators and families to assure that HIV-infected children receive the best education possible.
Key words: HIV, AIDS, school issues, confidentiality.
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