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Abstract

Cases of AIDS in children under thirteen years of age have been described since 1982. Diagnosis is more difficult in children than in adults, owing to the more varied clinical presentation and the difficulty in interpretation of laboratory tests. Current diagnostic criteria of HIV infection are reviewed, as well as symptomatology, natural history, and controversies surrounding management and therapy. Without a full appreciation of the transmissibility of HIV, issues including school and day-care attendance and foster family placement remain emotionally charged. Conflicting public policies contribute to fears on the part of the general public. Because ofthe unique implications for the entire family when a child is found to have HIV infection, the health care profession has been obliged to confront complex psychosocial issues unparalleled in modern medicine. The medical community may provide one safe environment for the family, and so the burden of providing support falls to a profession only variably trained and equipped for this task. In the absence of a vaccine or a cure, public education directed at primary prevention and reduction of stigmatization are the keys to true control ofthe epidemic.

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