My Children

Hello Dr. Hansfield, My compliments on the service that you provide to the many concerned individuals out there.  The reason for my entry today is due to the fact that recently I was informed that my brother-in-law is HIV positive.  He has lived a very promiscuous lifestyle and has been an avid drug user in the past.  Apparently, he was diagnosed 2 years ago and is on the appropriate medications to keep the disease at bay.  He also states that the HIV is barely detectable in his system.  I do not know the validity of his comments, for he is a born liar and cannot be trusted.  My concern and my wife’s concern is the fact that he has been in contact with our two very young children (ages 2 1/2 and 6 months).  The extent of his contact from our observations was saliva to non-broken skin contact (my children would sometimes put their hands in his mouth).  Their doctor stated that the children do not need to be tested, however, if they were his kids he would for peace of mind.  So the children were both tested on August 20th and the results were negative.  The doctor suggested a procedural follow up in 6 months.  The last contact the children had with their uncle was about 1 month ago.  I am not sure of the next time that he will see them due to his negligence in telling us that he was infected with HIV.  He cannot be trusted and his privileges are lost with my children. I want to know if my children are out of the woods and we can move on with our life, or do I have to be on pins and needles for another 6 months.  Your response is greatly appreciated.  Thanks!  

[H. Hunter Handsfield, M.D.]

Responding only to the title of your question ("My Children"), before even glancing at the question itself:  HIV is never transmitted to the children who reside in the home of an HIV infected person, unless there is sexual activity with the child; or if the child was born to or nursed by an HIV infected woman.

Now after reading the question:  I understand your concern, but it is based on emotion, not science.  Assuming your brother in law is not sexually abusing your kids, there is no transmission risk; with a very low viral load, he probably isn't even much of a risk to his sex partner(s).  From a risk/transmission perspective, he was not negligent in not informing you of his HIV infection.  (In fact, if this were a work environment--say, if he was a teacher or day care worker--in every state it would be illegal to ask his HIV status, since it makes no difference in transmission risk.)

From a family relations standpoint, he might have not used the best judgment.  Knowing that some people might react as you have, it would have been a kindness for him to inform you of the situation, while also reassuring you that he is not infectious.  But absolutely he was under no obligation, ethical or otherwise, to inform you of his HIV status, and it seems highly inappropriate for you to cut him off from your kids.  (Leaving aside the "born liar" and "cannot be trusted comments".  These may be reasons to keep the children away, but HIV is not.)  Also consider what message that sends to the children.  Do you want your kids growing up believing that HIV is transmissible in the household?  Or with a sense that gay men (or injection drug users, not knowing your in-law's HIV risk factor) are to be avoided?

Your kids never were in the woods.  You need to come out of the woods yourself, it seems.

HHH, MD

[Daniel25]

Alienating an HIV positive man isn't the kindest thing to do imho.
Just telling him to be very careful as it scares you and your wife should be enough, shouldn't it? I'm sure he will understand your concerns.

[Concerned Father32]

Thank you for your comments and I am sorry to include some much personal information regarding my brother-in-law.  I have never had an issue with his sexual orientation nor his drug use issues.  We believed our children were a source of joy in his life and we feel that he should have been honest with us regarding his status.  I thank you for educating me on the transmission risk, however, this recent action is a pattern of behavior that he has shown for years.  My reasons for keeping the children away from him are strictly because he cannot be trusted.  I meant this post as no offense to HIV positive individuals or gay people.  This is a problem with one individual.  Thank you for your expertise and easing my mind!  

[rolex4567]

This is most wonderful comment ever since in this forum. Risk or no risk, any person should not be barred from social life and right to lead normal life.

Raj