Chicago Tribune magazine examines HIV/AIDS among children, adolescents in U.S.

The Chicago Tribune Magazine on Sunday examined HIV/AIDS among children and adolescents in the U.S. According to the Tribune, there are about 6,000 children and young adults living with HIV/AIDS in the country.

The development of antiretroviral drugs in the 1990s has improved the lives of children living with HIV/AIDS and reduced the number of infants born with the virus from about 1,700 annually in the 1990s to about 150 annually today. Ram Yogev, founder of the HIV program at Children's Memorial Hospital in Chicago, said it is "unbelievable" that children with HIV now live into adulthood, adding that HIV-positive children had a life expectancy of three to four years in the late 1980s and eight or nine years in 1990.

Although the life expectancies and health of HIV-positive children have improved, children living with the virus "often are left to handle their HIV on their own and carry around this unseen burden that most people don't know about," Linda Walsh, a nurse practitioner at the infectious diseases clinic at the University of Chicago Medical Center, said. Kenneth Boyer, chair of pediatrics at Rush University Medical Center, added that HIV is a "constant and a very tough burden" for children living with the virus.

According to John Marcinak, medical director of the Adolescent HIV program at the University of Chicago, HIV-positive children "have more complications" than adults living with the virus "because they have been on medicine a much longer time." He added that the virus "can develop resistance to the medication" and that some children "can't use some of the new" antiretrovirals.

Robert Garofalo, director of adolescent HIV services at CMH, said that children living with HIV/AIDS are "a forgotten group" because the "sense of community" for other groups "does not exist" for them. "The youth who are born with HIV have very different issues with their family, parents and mothers," Garofalo said, adding, "But like all adolescents, they are still struggling to establish autonomy from their parents, to understand their emerging sexuality."

Lori Wiener, coordinator of the National Cancer Institute's Pediatric HIV Psychosocial Support Program, added that the "stress is tremendous" for children living with HIV. "The stress of HIV appears to increase beginning with adolescence," Wiener said, adding that HIV-positive adolescents "fear social rejection more than many of them fear dying" of AIDS-related causes. Children and adolescents living with HIV/AIDS "who have done the best psychologically are those who have people in their lives that they share their diagnosis with and can talk to openly" about HIV/AIDS, Wiener said (Breu, Chicago Tribune Magazine, 5/11).