Through your foster care training you will have received general training on providing support to children who have experienced difficulties in their lives. However this training probably did not cover HIV.
It is important to think about the kinds of experiences a child may have had as a result of living with HIV. Here are some key points that will help you:
HIV in the family
Most children who are living with HIV in the UK have contracted it from their mother. This means they come from families where at least one other member of the family is living with HIV.
As HIV is a family condition, some children may have suffered multiple bereavement. This will have a dual impact: the experience of childhood bereavement on a child and the fear for their own mortality, as they live with the same condition. For more support and understanding of bereavement issues, visit Child Bereavement UK.
Stigma & Secrecy
The child is living with a highly stigmatised, life limiting illness. This can be a lot of pressure for them to manage. When a child is told they have HIV (which may not happen until they are 10, 11 or older) they are then told not to tell anyone else. Living with this secrecy can have a big effect on children, how they internalise the social stigma of HIV and their relationship with their medicine. Having someone to trust and talk to could be a big relief to them.
The anti-retroviral medication HIV positive people take can work extremely well if taken properly (the right amount at the right time), but some can have nasty side effects and children can struggle with these. It also acts as a reminder that they have HIV, and can remind them of past bereavements or their fears for the future. Some children may need support with their medication.
Sometimes there are things that can be done to make this easier, perhaps by changing the types of medication needed. You may be asked to remind the child you foster to take their medication, or may need to advocate for them in health settings.
Open and honest conversations about HIV
Even though a child may have HIV, it does not necessarily mean they understand it. They may be fearful about their own future and mortality. They may not actually understand what HIV does to their body and what they can do to live well.
You are not expected to be an expert in HIV, but together with the child, you could find about more about it through the youth pages of this website, materials in CHIVA's resource library and through other organisations. Together you can find out more and this could act as not only an educational activity, but one that builds a bond with the child and allows for more questions to be asked.
An older child may have lots of questions about sex and sexual health. This is an area many struggle with, as they are born with a highly stigmatised sexually transmitted infection but have the same sexual feelings as their HIV negative peers. Understanding how HIV is transmitted and how to keep yourself and your sexual partner safe is important and there is more information on this for parents and carers.
Your support needs
As a foster carer you will know how important it is to receive support in your role. You will have a social worker and perhaps access to support from groups, etc. However you may not be able to discuss the issues to do with HIV with these people. It is possible your social worker will not know the child you are fostering is HIV positive.
If you do need to talk to someone, any professional who is working with the child in relation to health care and support around their HIV (such as the child’s nurse, social worker or specialist support worker) would be a good person.
It is important that there is a good professional network of support around any looked after child and as you know, you play a pivitol role as a foster carer. Make sure you establish a relationship with those HIV professionals who care for the child so you always have someone to go to when you need to discuss any issues which arise, or you want to talk about your own feelings and concerns.
The National Children’s Bureau has published a document, Looking After HIV: Considering the needs of HIV positive looked after children, which explores the experiences of HIV positive looked after children. This includes a section on the experiences of HIV positive children in foster care.