FAQ

Q: (as was posted on my Christian Ethiopian Adoption Yahoo Group) Are most of the children from Ethiopia AIDS orphans? And..If the birth parents have AIDS or die from it, how can the children not have it, especially young children? Wouldn't they be exposed in utreo and during birth? Are the HIV/AIDS tests given in Ethiopia accurate?

A: These were questions that I had, too, at the beginning of my adoption journey. As I educated myself, I came to believe that under different circumstances, I could, and would, adopt an HIV+ child. I had the pleasure of meeting an HIV+ child recently adopted into the US, and I can tell you this- she was just like any other little girl, and I had no problem letting Abigail play with her. Her HIV status would not have inhibited me from loving her, and I am thankful that she is here in the US and she is healthy!

Here is my response to the question above.

I would suggest that perhaps you and your hubby read "There Is No Me Without You." This book will help you gain a better understanding of the orphan epidemic in Ethiopia.

Children in Ethiopia may be AIDS orphans. However, they may be relinquished due to poverty or other reasons as well. For instance,in Ethiopia, a widowed woman has very little hope of remarrying. Remarrying is one of the only ways she can gain any kind of financial security. Having children from her previous husband makes remarrying even more difficult. So, since she probably can't provide for her kids, and she almost certainly will not remarry if she keeps her kids, she may choose to relinquish them.

I don't think that there are any accurate numbers for how many of the Ethiopian orphans are orphaned by AIDS. But in a world where a woman may work all day and earn only a few cents, the reality is that children are orphaned by poverty just as much as by disease. Additionally, AIDS is not the only disease that can orphan children. Many diseases that are not fatal in developed nations are certainly fatal in developing nations like Ethiopia where access to health care is limited and there is no health care for people who cannot pay for it. TB, malaria, polio, etc can all be causes of illness and death.

Parents may acquire HIV and die from it after children are born. Additionally, just because one or both parents are HIV+ does not mean that the children born of them will be HIV+ as well. In fact,studies from other nations have shown that a child is more likely to acquire HIV from breastfeeding from an HIV+ mom than from being born of an HIV+ parent.

All children are tested for HIV when they are admitted to an orphanage. Depending on your agency, you may have the option of having additional HIV tests done (in general, the real question of accuracy of the HIV tests has to do with which kind of test is done, the age of the child at the time of the test administration, and how recently the child may have had exposure to HIV through birth or breast milk. That is a long and complex discussion, but suffice it to say that with enough HIV tests done at the appropriate times, you can almost certainly trust the negative results of the tests.) Children are also tested for other communicable diseases when they come into the orphanage.

HIV+ children are, generally, not housed with HIV- children once they go into agency-run orphanages. Additionally, to bring an HIV+ child into the US, you have to go through a special procedure with USCIS. If you don't want to adopt an HIV+ child, you can feel confident that you won't, as the children as also tested for HIV at the American Embassy in Addis before they are permitted to leave Ethiopia.

Please keep in mind that HIV/AIDS is not as scary as it used to be. Because of the amazing anti-retroviral (ARV) drugs that we have, children who are started onto ARV therapy have a life span that is equal to that of an HIV- child. In fact, an HIV+ child who receives ARV therapy in the US will die of a heart attack, stroke, or other "diseases of age" before they die of HIV/AIDS. A child who is HIV+ is not likely to advance to AIDS if they are receiving ARV therapy.

HIV is not likely to be spread to family members or friends. In fact, in a hospital setting, the precautions we take for HIV+ patients are no different than the precautions we take for an HIV- patient, since it kind of takes a lot to acquire HIV. Since I am not sharing needles or having sex with my patients, I can't get HIV from them. It's that simple. The HIV virus is very unstable and cannot live on surfaces, so things like sharing a bathroom or sharing linens does not increase your risk of contracting HIV.

Certainly, adopting and parenting an HIV+ child has it's risks, and it is not for everyone. But I think that there is still this unfair stigma surrounding HIV. You and your husband probably interact with HIV+ people in your daily lives and you don't even know, because HIV is not a "killer" in the US the way it is in developing nations. It is a serious disease, but in the US, it is a manageable chronic condition just like high blood pressure or diabetes. And we know that people are more likely to die from high blood pressure and diabetes than from HIV in the US because of the wonderful medications we have available to us.