7.6.3.1: Attendance of Children with HIV

Children infected with HIV should be admitted to child care as long as their health status allows participation in program activities. Children who enter child care should not be required to be tested for HIV or to disclose their HIV status (1,2). HIV is not spread by the type of contact that regularly occurs in child care (1). Standard Precautions should be adopted for handling all blood and blood-containing body from all children (1,2).
If exposure to a highly contagious disease (such as measles or chicken pox) occurs at the facility, parents/guardians of all children, including children with HIV, should be notified as they can pose a serious health risk to children with compromised immune systems (1).

RATIONALE

Overall, the risk factor for transmission of HIV is low because HIV is not spread by the type of contact that typically occurs in child care. HIV is not spread through non-bloody saliva, tears, stool, or urine (1). 

COMMENTS

If the program is aware of a child attending with positive HIV status and there is a strong risk of transmission of blood-borne pathogens occurring, it is recommended the child’s health care provider, parents/guardian, and the program director meet to assess whether the child can participate in group care activities. Examples of high-risk transmissions are: generalized dermatitis, bleeding problems, or biting (1). A public health authority with expertise in HIV prevention/transmission or the child’s health provider should be consulted as specific issues regarding participation arise.
For additional information regarding HIV, consult the current edition of the Red Book from the American Academy of Pediatrics (AAP).

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.2.3.4 Prevention of Exposure to Blood and Body Fluids
3.6.1.1 Inclusion/Exclusion/Dismissal of Ill Children

REFERENCES

1. Aronson, S. S., T. R. Shope, eds. 2017. Managing infectious diseases in child care and schools: A quick reference guide, 4^th Edition. Elk Grove Village, IL: American Academy of Pediatrics.
2. American Academy of Pediatrics. Human Immunodeficiency Virus (HIV) In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st Edition. Itasca, IL:  American Academy of Pediatrics; 2018: 401, 459-476, 506

NOTES

Content in the STANDARD was modified on 3/31/17.