Caring for children with AIDS: new challenges for medicine and society.

Abstract

Caring for HIV-infected children under 13 years of age poses a serious and steadily increasing challenge to our society. Children with AIDS face devastating medical and psychosocial problems. Because of the unique implications for the entire family when a child is found to be HIV-infected, the health care profession is obliged to confront complex legal and psychosocial issues heretofore unparalleled in modern medicine. Decisions that concern schooling and daycare for the asymptomatic but HIV-seropositive individual are often influenced more by public frenzy than scientific information. Issues regarding reproductive choice and responsible parenthood are all confounded by debilitating and eventually fatal illness in infected parents. Problems of custody and foster care require innovative strategies to avoid further burden to an already stressed system. AIDS has become a disease for which research is standard of care. Access to experimental protocols is complicated by geographic location, public funding, and complexities of informed consent. The responsibility of the physician to an individual patient must be considered, and must be given its proper place within the broader responsibility to science and society.