Pediatric AIDS: adolescence, delinquency, drug abuse, and AIDS.

Sexual promiscuity often is part of the lifestyle of teenagers who are delinquent and abuse drugs, and that behavior puts them at increased risk of contracting HIV infection/AIDS. Many of these juveniles are runaways or live in disorganized homes, and as a result they are hard to reach and it is extremely difficult to provide health and other services to them. Indeed, these youths at risk most frequently may be identified and helped when they run afoul of the law and enter the judicial system.

Pediatric AIDS: psychosocial impact.

There is no question that the domain of the American family has been invaded by the HIV infection/AIDS epidemic. The disease, and particularly its form affecting children (pediatric AIDS), has had marked psychosocial impact on patients and families (intellectual/cognitive, emotional/behavioral, spiritual, and financial) and on our society in general (adverse or favorable). These impacts of pediatric AIDS are discussed in the present communication.

Pediatric AIDS: systematic approach to patient management.

In order to provide comprehensive care to infants, children, and adolescents with HIV infection/AIDS, a systematic approach to clinical management had to be developed. This approach involves "case management" by experienced health professionals, including initial evaluation and needs assessment, planning of services, brokerage of services, continuity of intervention until an outcome is reached. The care is delivered in hospitals, clinics, homes, residential facilities, respite care centers, and hospices.

Pediatric AIDS: impact on health systems.

For 9 years we have recognized HIV infection/AIDS as an unstoppable epidemic affecting infants, children, and adolescents as well as adults. Now we see the tremendous impact of this disease on the health systems of this country. During these past 9 years, we have witnessed the transformation of the epidemic from one primarily affecting male homosexuals to one invading the average US family through heterosexual and vertical transmissions and through needle-sharing practices of intravenous drug abuse.

Pediatric AIDS: prevention of HIV infection in infants and children.

The Centers for Disease Control reported that 109,167 cases of AIDS had been diagnosed since 1981 and that approximately 40,000 persons were living with AIDS at the time of this writing. These numbers, however, are the tip of an iceberg that consists of approximately 1.5 million Americans who are infected by the human immunodeficiency virus (HIV).