SCHOOL-RELATED ISSUES AMONG HIV-INFECTED CHILDREN

Objective. Many children with human immunodeficiency virus (HIV) infec tion are surviving long enough to reach school age. This study describ es issues related to school attendance and disclosure of HIV infection in a population of HIV-infected children. Methods. A statewide pediat ric HIV surveillance system was used to collect data on school-age (5 years old) HIV-infected children. In addition, HIV clinic nurses famil iar with the child's history participated in a cross-sectional survey that collected information on school-related issues during the 1993-19 94 school year. Results. Of the 92 school-age children, only 3 were to o ill to attend school. Another 5 children were home-schooled. Of the 84 who attended school outside the home, 25% had severe symptoms of HI V infection (Centers for Disease Control and Prevention [CDC] clinical category C). Absence from school ranged from less than 2 weeks during the year for half of the children (51%) to more than 8 weeks for 9 ch ildren (12%). Twenty-nine percent of the children received medication in school, usually administered by the school nurse. Over two thirds o f the 50 children ages 5 to 10 years had not been told that they had H IV infection. Only 1 of the 20 children more than 10 years of age was not aware of her HIV infection. For 53% of the children attending scho ol, no school personnel had been informed of the child's HIV infection . Administration of HIV medications at school, age of child, and treat ment at one particular HIV clinic were associated with the parents' de cision to inform school personnel. In the 47% of cases where the schoo l had been informed, school nurses were most frequently notified, foll owed by principals and teachers. Conclusion. Only 3% of school-age chi ldren were too ill to attend school, and almost all were enrolled in p ublic schools. The number of HIV-infected children reaching school age will continue to grow, and public schools will bear the responsibilit y for educating these children. Health care providers will increasingl y be called upon for guidance by both educators and families to assure that HIV-infected children receive the best education possible.