HIV: What Every Church Child-Care Worker Should Know
Elizabeth Styffe

Fear is alive and well in the church nursery.  The phone frequently rings with slightly- panicked parents asking what “special precautions” are being taken in the nursery because someone heard a baby has a parent who is HIV positive or worse yet, that the baby is HIV positive too.  Fears abound that the virus may run rampant amongst others.  The fears are real, but the reality of HIV spreading to others in a church nursery or playground setting is not real. Here are three reasons why your nursery is okay and three things you should know if you work with children who carry the virus.

3 Reasons Why You Don’t Need to be Afraid of Infants/Children Who are HIV Positive in Your Nursery.
1.  HIV is not lurking around every corner.
HIV is rare in children in the United States (this does not mean you shouldn’t care about HIV and take precautions against any illness that can be transmitted.)  It does mean that HIV is not lurking in every church nursery. This may not allay the fears of the person who is sure they will contract the virus, but the average church care worker needs to know that their risk of even seeing a child who is positive is small.

2.   HIV is not transmitted in the ordinary lives of children.
Even if you are caring for a child who is positive (and I pray that you will care for more than one child because there are over 3 million HIV positive children in the rest of the world who need to find their way into someone’s arms), HIV is not transmitted in the ordinary care of children, including normal diaper changing and playing.

Here is virus lesson 101 as it relates to children:
Note:  If you’re a microbiologist, don’t read this.  The generalities and simplicity will annoy you. 

• The virus is found in blood.  When was the last time you changed a bloody diaper?  “Aha,” you say, “I have taken care of children who bumped heads and were bleeding profusely.”  Yes, but even if HIV infected blood is present, the virus is fragile, so the virus often dies on it’s own outside of the body.
• And if that weren’t enough, the particular amount of virus in the child’s blood may be small, which may mean that there is not enough virus present to give to another person. (Children don’t usually exchange large amounts of blood which is why there is no documented case ever of children in a normal routine transmitting HIV to another).
• And if that weren’t enough, the blood of the infected child (with a sufficient amount of virus to infect another) has to “get inside” another person.  This is very important.  Remember this is not done by inhaling the air or touching the skin, the blood of an infected child has to get into the bloodstream of the other child. (I don’t know many children who share syringe needles).  Just bumping heads is not sufficient for the blood to “mix” and enter into another in a significant way.  (Thankfully, this has been tested many times on playgrounds all over the world).  This also explains why sharing eating utensils, even with an HIV infected person who has blood in their mouth, is not a risk…. (even though I personally don’t recommend it because it sounds very distasteful).  In this example, for the microbiology impaired like me: 
  •  There is an insufficient amount of blood (virus)
  •  Usually a virus does not survive in the environment
  •  And there generally is no mechanism for HIV to enter the other person’s bloodstream (except possibly the inside of the mouth, which is not a very effective way to absorb blood into the bloodstream).
  3. HIV transmission is already being prevented by the other ordinary health measures you are doing for your nursery programs, including wearing gloves when changing diapers and washing hands. (Don’t’ forget the importance of these practices for hepatitis, and other lovely pathogens too).  You already have safety mechanism in place that will help avoid any blood-related or stool-related illness such as Hepatitis or HIV.  The nurse-types call this “universal precautions” providing safety for yourself and others.  Some church nurseries have forgone the “change every baby” practice just to reduce the risk of other diseases. If you are interested in more guidelines check the CDC (Center for Disease Control) website http://www.cdc.gov/.  

   

  3 Things You Should Know If You Work With Children

  1. Children who are positive are not putting you at risk. Realize that your greatest risk is not from the child whom you know is HIV positive, (because you’re more likely to take precautions) but from the children whom you don’t know their HIV status.
  2. Children who are positive need privacy and confidentiality.  If the parent reveals the child’s status to you, it does not mean you can share this information with others. 
  3. Touch them.  Reduce stigma and affirm the child as a child.  Remember children are not HIV positive children; they are, instead, children who are HIV positive.