RESOURCE SHEET # 33 Canadian Child Care Federation

HIV/AIDS AND CHILD CARE

HIV (Human Immunodeficiency Virus), the virus that leads to AIDS (Acquired Immune Deficiency Syndrome), is not transmitted through everyday contact. HIV is a fragile virus, and no cases of transmission through casual contact have been reported in a child care setting anywhere in the world.

HIV is not transmitted by:

• touching, hugging, or kissing;
• sharing food, dishes, drinking glasses, or cutlery;
• being coughed, sneezed, or cried on;
• sharing toys, even those that have been mouthed;
• diapers or toilet seats;
• urine, stool, vomit, saliva, mucus, or sweat (as long as it is untainted by blood).

HIV is transmitted from one person to another by sperm, vaginal secretions, breast milk, blood, and body fluids containing blood, usually through unprotected sexual intercourse or the sharing of contaminated needles. It is also transmitted from mother to child during pregnancy or delivery or by breast feeding.

Simple contact between blood and intact skin is not enough to transmit HIV. Three conditions are necessary for transmission:

• The blood must be fresh.
• There must be a sufficient quantity.
• It must have a route of entry into the bloodstream of the uninfected person.

Biting often concerns parents, but there has never been a confirmed case of transmission by biting. To risk transmission, a child infected with HIV would have to have fresh blood in his mouth and break the skin of an uninfected child. An uninfected biter would have a theoretical risk of exposure only if he broke the skin of a child infected with HIV and drew blood into his mouth. Such events are very unlikely.

Parents also worry about accidents and fights, but fresh blood-to-blood contact among children is extremely unusual.

Children infected with HIV have the same right to attend child care as other children. HIV is considered a disability, and by law discrimination on the basis of disability is not allowed. Staff also cannot be discriminated against, fired, or non-renewed because of their HIV status.

Child care plays an important role in the lives of children infected with HIV, offering them peers, stimulation, stability, and the chance to learn new skills. A child's parents, physician and social worker will decide whether child care is suitable and monitor the child's progress.

Child care staff probably will not know if a child is infected with HIV. Many children have no symptoms, and if no one in the family has been diagnosed as HIV-positive, the family may not even suspect that the child has the virus.

If the parents know, they have no obligation to tell the centre. Because they may fear discrimination, they may keep the information to themselves. If they decide to tell an educator, he or she has an ethical obligation to keep the information confidential. There is no need for the parents of other children to know since a child with HIV poses no danger.

It is important for child care centres to develop a health policy that respects the rights of all children and staff to privacy and confidentiality. For everyone's protection, the policy should include the use of universal precautions and proper hygiene, procedures for informing parents about contagious diseases, and procedures for excluding sick children and children with serious behaviour problems.

UNIVERSAL PRECAUTIONS - Adapted for Child Care Settings