Kids and AIDS

AIDS will always be part of our children's lives. Thousands of young people have already been infected through unsafe drug and sexual activities. Thousands of others have been born with the virus. And thousands more are faced with the illness of people they love and care about.

AIDS challenges us to make survivors of our children. We must prepare them for happy, healthy, and fulfilling lives despite the specter of this epidemic. We must teach them how to protect themselves. We must cherish those who become ill. And we must help them all learn to cope with the losses they will experience.

Knowledge and self-confidence are our kids' best protection against AIDS. We can teach them to protect themselves, understand and assist those who live with the disease, and put AIDS into its real perspective in their lives.

Children are eager to learn. We only have to take advantage of their eagerness.

What Are The Risks?

We are all sexual — from the day we are born to the day we die.

But it is difficult for many of us to accept that our children are sexual. It may be even harder to think they might use drugs. But no matter how hard it is, it's up to us to make sure that our children do not make decisions about sex and drugs out of ignorance or fear.

Kids under 20 are at very high risk of getting HIV:

• Teenage women and men have the fastest increasing rates of HIV infection in the U.S.
• More than 63 percent of U.S. teens have vaginal intercourse before they graduate from high school.
• More than 10 percent do not graduate, and those who drop out have increased rates of drug use.
• Women and men between 15 and 25 have the highest rates of sexually transmitted infections in the U.S.
• Kids have a strong sense of adventure, but lack the life experience to fully understand their risks — especially when it comes to sex and drugs.
• Kids are very sensitive to peer pressure.
• AIDS can be caused by only one exposure to HIV.

Gay teens are at increased risk. They are likely to forego health care and social services because they fear ridicule and humiliation. Very often they are unable to turn to their families for information and support about their sexual concerns. That is why lesbian and gay teens are more likely than straight kids to live on the street, attempt suicide, and involve themselves in other high-risk behaviors.

Remembering our own teen needs, inhibitions, and fears about sex may make us more compassionate and understanding.

• What were the risks we took?
• How did our own inhibitions set us up for risky behavior?
• How often did we take chances rather than face discussing sex with our sex partners?

Remembering our own childhood and adolescence can help us help our children deal with theirs.

Give Kids The Gift Of Self-Protection

Gift #1. Good Role Models
Our children learn most from our example. Our behavior molds their ideas and feelings about how people get along with one another. They imitate what we are, not what we want to be. That's why telling children to "Do as I say, not as I do," fails to do the trick.

Gift #2. Self-Confidence
Children who are self-confident are more likely to make healthy decisions. Self-confidence helps them overcome peer pressure, say no to too-early and unsafe sex, and avoid sexual and drug abuse. Praise is the best way teach to self-confidence. We should praise honesty, independence, talent, effort, fair play, taking responsibility, kindness, and good decision-making. We undermine our children's self-confidence when we ridicule, humiliate, shame, or bully them.

Gift #3. Positive Feelings About Sex
We must expect our kids to take pleasure in their bodies. People who have positive feelings about their bodies, sex, and masturbation are more likely to be able to protect themselves against sexually transmitted infections, unintended pregnancy, and sexual abuse.

Gift #4. Sound Decision-Making Skills
We must encourage children to make choices and decisions from their earliest years. Offering options instead of giving orders lets them become good decision-makers. Practice with small decisions prepares kids for making bigger ones.

Gift #5. Trust
We must always be there for them — keeping the lines of communication open — no matter what errors in judgment they make. They must know that we will be patient and reasonable, no matter what trouble or concern they bring us. We must be able to listen to whatever they say without "flying off the handle."

Gift #6. Feeling Normal
What kids want most is to know that they're "normal." We can help them understand that it is "normal" for everyone to be different. In fact, the most important lesson we can share with our kids is just that — Being different is normal.

In addition to Good Role Models, Self-Confidence, Sound Decision-Making Skills, Trust, and Feeling Normal, kids need Knowledge and Information to protect themselves against AIDS.

Ten Basic Facts Kids Need To Know

1. AIDS is the last stage of HIV disease.
AIDS is the acquired immune deficiency syndrome.
HIV is the human immunodeficiency virus.

2. Currently, HIV disease is ultimately fatal.

3. There is no cure.

4. There are only a few ways to get HIV.

There must be an exchange of blood, semen, or vaginal secretions. The most likely ways are

• having unprotected sexual intercourse
• sharing needles and other drug equipment
• being born with it

HIV can also be passed to an infant through breast milk.

5. Most people with HIV don't know they have it.
It can take more than 10 years before symptoms develop. Most people with HIV pass the virus to someone else without knowing it.

6. You can't get HIV by casual contact.
There is not enough exchange of blood, semen, or vaginal secretions in casual contact — hugging, kissing, touching, swimming; or by sharing sandwiches, eating utensils, swimming pools, showers, towels, and gym equipment — to cause HIV infection.

7. The surest way to avoid HIV is not to use IV drugs or have anal, vaginal, and oral sex.

8. Practicing "safer sex" reduces risk for sexually active people.

9. Satisfying sex lives are possible in the age of AIDS.

10. Getting HIV from a blood transfusion or medical procedure is very unlikely.
Donated blood has been screened for HIV antibodies since 1985 when the first test was developed. The chance of getting HIV from other procedures is less than one in 10 million.

Talking With Children About Aids

The key to helping kids understand the 10 Basic Facts About AIDS is to talk about the facts often. Make it a relaxed and easy part of every-day conversation. Don't let AIDS be an isolated issue or the subject of a single lecture. Include AIDS whenever you talk about sexuality, love, drugs, friendship, health, and other related subjects.

Be frank, open, and honest, but remember to respect the need for privacy. For example, it is not necessary to ask if a child masturbates or "plays doctor." If we think about our own need for privacy, we can appreciate the importance of our children's needs. And remember, we don't have to know everything. If we are asked something we don't know, we can say we'll find out.

A sound sexuality education is the basis of a sound AIDS education. It begins at birth:

Pre-School Children

Birth to Two
We give babies their sense of sexuality from birth. We make them feel secure or insecure by

• how we hold and touch them
• how we feed, wash, and diaper them
• the tone of our voices
• letting them feel comfortable with their bodies and emotions

They can develop healthier feelings about their sexuality if we do all these things in a pleasant, loving, and caring way.

It is normal for babies to explore their bodies. They are quick to learn that touching their sex organs feels good. We should allow them to enjoy this without making them feel "naughty." Otherwise, they may not trust us later in life when they're looking for guidance about sex. It's just as important to react positively to their bowel movements and other body functions, too.

Three To Five Years
We must let pre-school kids feel free to ask about their bodies, health, sexuality, and adult relationships. To do this we can

• Talk openly and frankly about these subjects in their presence.
• Talk about these subjects with them.
• Avoid teasing or ridicule when sex is the subject.

Pre-schoolers' questions will be as open and frank as we allow. They are ready to know that women and men have different sex organs. It's important to talk about sex organs in the same relaxed way we talk about elbows and noses. It's better to use the right names for sex organs — "vulva," "penis," and "breasts." Otherwise, kids may get the idea that something is "wrong" with these parts of the body.

Toddlers are curious about the bodies of their parents and other children. They may play "doctor" to look at each other's sex organs. This is a normal way for kids to learn about their sexuality. Punishing them for this may weaken their ability to make healthy sexual decisions as adults.

Children this age hear a lot about AIDS. We must take care to relieve them of groundless AIDS-related anxiety. They need to be reassured that

• They are not at risk for AIDS.
• AIDS will not be their punishment for "being bad," for wetting the bed, or for biting their nails.
• HIV is not like the germs that we get from breathing, sharing food, or being to close to people.
• Their parents are protecting themselves from the virus.

If specific questions about HIV/AIDS are asked, they should be answered in a simple and straightforward way. For example, "How does a person get AIDS?" can be answered, "A special AIDS germ gets into the blood.""Will I get AIDS for wetting the bed?" can be answered very simply — "No."

Unless pre-schoolers have more direct questions, further details are usually unnecessary. But we can set the stage for when they are older. For example, bandaging a playground wound is a great opportunity. We can ask, "Do you know why we put a bandage on a cut besides to make it feel better? The bandage keeps out germs that might make you sick." This simple idea can help kids begin to understand what "germs" are about.

Young Schoolchildren

Five to Seven
Young school kids may be less outgoing than pre-schoolers. They hear lots of talk about AIDS, rape, and child abuse, and they wonder and talk about these things with one another — even if they don't say anything to us. So, we can't wait for them to ask us about these subjects.

Kids at this age begin to sort out masculinity and femininity. They begin to take care of their own bodies, health, and safety. They have "sexy" thoughts about friends and relatives of both genders. We mustn't let them worry about it. And when we discover children fondling their genitals, we need only say, "I know that feels good, but it is a private way to feel good. Let's find a place where you will have the privacy you need."

Young school kids want to know what AIDS is, how people get it, and how to avoid it. They have questions about what they hear on television and in the playground. Parents will need to know the facts in order to provide answers such as

• "No, you can't get AIDS from a mosquito bite."
• "The germ for AIDS can be in blood or in a man's semen."
• "Yes, you can share your lunch with other children without being afraid of catching AIDS."
• "No, AIDS is not a punishment for being bad."
• "Yes, you can play with Vivian without catching AIDS."

It is important to remember that there have been no known cases of AIDS caused by physical contact generally associated with children and child play. This includes biting, wrestling, and sharing food.

Sexually abused children often believe they are responsible for the abuse. Increasing numbers of these children develop "AIDS anxiety." They believe that AIDS will be their punishment. Children with AIDS anxiety may be reacting to difficult emotional situations. Professional counseling can be beneficial.

Pre-Teens

Eight to Twelve
Children become very interested in issues of sexuality as they enter puberty. They need all the facts about menstruation, wet dreams, and other signs of maturing.

Pre-teens worry a lot about whether they are "normal." Boys worry about their penis size. Girls worry about their breast size. We must reassure our children that no two people are the same — that it is normal to be different.

We need to let pre-teens "fit in" with their peers. But we must encourage them to think for themselves and not get carried away by the crowd.

During puberty, kids are often very shy with us about what's going on with them. They prefer talking with friends.  We have to be sure that peers aren't their only source for information about sex and drugs. Never hesitate to open a conversation about sexuality and health with pre-teens. We can take the opportunity while watching television, talking about the news, or when we hear our kids and their friends talking together.

Children at this age need a lot of explicit information. They need to know the details about what AIDS is, the details about how people get it, and the details about how to avoid it.

They need to know about safer sex, homosexuality, and oral and anal sex. They need to know that alcohol and other drug use weakens their ability to make good judgments. And they need to understand that sharing IV drug equipment is an almost foolproof way to get HIV.

Once we get discussion going, we need to be prepared for questions like

• "How many sex partners did you have in your life?"
• ""What kind of birth control did you use?"
• ""Do you masturbate?"
• ""If you don't have AIDS, why do you use condoms?"

We can ask to have our privacy respected, but when we do decide to answer, "honesty is the best policy" — with our kids and with ourselves.

Teens

Teenagers are naturally adventurous. But they don't have enough life experience to help them gauge their risks by themselves. They may also think that disease and death are only problems for older people. But it is also true that teens can be motivated to take good care of themselves and one another. We have seen how hard they can work to help support their families, get into college, or save up for a special gift. These efforts demonstrate real ability to prepare for the future and take care of themselves.

Teenagers get a lot of bad press. But for every teenager who only seems interested in immediate gratification, there are many who are motivated by high ideals, generosity, and long-range goals. If we take advantage of our teens' capacity for idealism and generosity, we will more likely succeed in helping them learn self-protection. The more positive our approach, the better.

Teenagers must be helped to understand the Ten Basic Facts Kids Need To Know. But most of all they will need to know about safer sex.

Safer Sex
The safest sex of all is no sex. We must help young people become self-confident enough to say "no" to sex — despite peer and social pressures. But they also have to know what "safer sex" is. Sooner or later, most of themdo decide to become sexually active. They need to be prepared to protect themselves before that happens.

Safer sex decreases the exchange of semen, vaginal fluids, and blood between partners. It lowers the risk of transmitting HIV while having sex.

The safest sexual activities include: hugging, kissing, cuddling, fondling, massage, and mutual masturbation.

The riskiest sexual activities are unprotected vaginal and anal intercourse.

The Condom

Latex and female condoms prevent the exchange of semen, vaginal fluids, and blood between sex partners. They should be used for sexual intercourse every time unless

• both partners have no sexually transmitted infections
• both partners have no other partners
• neither partner shares needles

Preventing disease and unintended pregnancy are both important during vaginal intercourse. Only latex and female condoms offer effective protection against both HIV and pregnancy. To prevent infections, users of other contraceptives should also use a latex or female condom every time they have vaginal intercourse.

The most important ways to reduce your risk are

• Keep your partner's body fluids out of your body — vagina, anus, or mouth. The body fluids to be most careful about are blood, cum, pre-cum, vaginal fluids, and the discharge from sores caused by sexually transmitted infections.
• Don't touch sores or growths that are caused by sexually transmitted infections.

"Safer Sex" HIV Risk-Comparison Chart

Very Low Risk — No reported cases due to these behaviors

• masturbation — mutual masturbation
• touching — massage
• erotic massage — body rubbing
• kissing
• oral sex on a man with a condom
• oral sex on a woman with a Glyde^® dam or plastic wrap

Low Risk — Rare reported cases due to these behaviors

• deep kissing
• oral sex
• vaginal intercourse with a condom or female condom
• anal intercourse with a condom or female condom
  (Try not to get semen or blood into the mouth or on broken skin.)

High Risk — Millions of reported cases due to these behaviors

• vaginal intercourse without a condom
• anal intercourse without a condom

Some Drugs That Encourage People To Take Risks With Sex

• alcohol
• cocaine
• ecstasy
• poppers
• crystal meth
• speed
• downers
• crack
• acid
• heroin
• marijuana

Some Feelings That Encourage People To Take Risks With Sex

• passion
• shame
• embarrassment
• desire to be swept away
• insecurity
• fear of losing a partner
• anger
• desire to be attractive
• shyness
• low self-esteem
• grief
• need to be wanted

Knowledge and good judgment are the most important elements of safer sex. Alcohol and drugs impair judgment and should be avoided whenever having sex is a possibility.

Drug Use

Parents should be able to discuss the use of IV drugs and its consequences with their children. The same gifts that help kids protect themselves against AIDS —Good Role Models, Self-Confidence, Sound Choice-Making Skills, Trust, Feeling Normal, Knowledge, and Information — will help prevent drug use.
People who share equipment for "skin popping," IV drugs, or steroids, are at great risk of contracting HIV and should stop using. Until drug users successfully complete treatment programs, it is important that they

• Buy and keep their own equipment.
• Refuse to share needles or other drug equipment.
• Keep their equipment where others cannot find and use it.
• Know that sometimes re-bagged used needles are sold on the street as new.
• Get involved in a needle-exchange program.
• Clean needles with bleach or alcohol if forced to share.

Parents and caregivers who want more information can call the National Institute on Drug Abuse, Drug Information, and Treatment at 1-800-662-4357.

Death And Dying

Many kids face death and loss because of AIDS. It is important to acknowledge their need to grieve as they anticipate and experience loss. We should be sure to include them in all family discussions, visits, and ceremonies that are part of the grieving process. Taboos against including kids in these events are misguided. For healing to take place, children must be allowed their goodbyes.

Young people may need help dealing with grief, just as they do with issues of sexuality and health. Family Service America is a nationwide resource for counseling children and families experiencing grief. To find the location of the nearest affiliate, call 1-800-221-2681, or write Family Service America 11700 West Lake Park Drive Milwaukee, Wisconsin 53224

The Future

There still is no cure for AIDS or HIV disease. But one thing about AIDS is very reassuring for people with HIV, their families, and friends. Compared to other communicable infections, HIV is hard to get. HIV is not carried by air or water, in food, or by insects or animals. It is not passed on by casual contact with those who have been infected with it. Parents can reassure themselves and their children that, with knowledge and good judgment, AIDS is entirely preventable. Wanting to avoid it is the first step. Young people will want to if we help them feel secure, informed, and loved.

© 2002 Planned Parenthood Federation of America, Inc. All rights reserved.