Babysitter just diagnosed with HIV......
November 12, 2009 4:03 AM   Subscribe

DESPERATE! Babysitter diagnosed with HIV......

The babysitter for our 17 month old granddaughter has been diagnosed with HIV. To make matter worse she is a family member of my daughter-in-law. What next ???? How do we handle this situation? I am trying very hard not to overeact - but - I need information and help before I jump out of my skin!!!!
posted by pamspanda to Health & Fitness (41 answers total) 4 users marked this as a favorite
I'm not sure what the problem is, unless you're the baby sitter. She's not going to sneeze on your baby and give it HIV. It takes more than casual contact to spread it.
posted by motorcycles are jets at 4:08 AM on November 12, 2009 [9 favorites]

Read this, particularly this:

"HIV has been found in the saliva and tears of some persons living with HIV, but in very low quantities. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV."
posted by Jaltcoh at 4:11 AM on November 12, 2009 [1 favorite]

HIV or aids or what? I'm just asking because a lot of people use the terms interchangeably when that doesn't really work.

Is she going to be and has she ever been a danger to the child?

How did you find out? If she told you and you freak out (like you don't want to do) then there could end up being some trust issues between people. Same goes if someone else in the family told you.

There are a number of ways to catch (and not catch) HIV. As long as there's no blood passing between the babysitter and the child (because I'm assuming >99% of the other ways of passing it aren't happening) then you should be fine.
posted by theichibun at 4:13 AM on November 12, 2009

Don't let your babysitter have sex with your baby! Transfusions are right out! Breastfeeding is questionable.

Otherwise, give your babysitter the love and support she needs. She's not a pariah, she's just got an autoimmune disorder.
posted by Pollomacho at 4:15 AM on November 12, 2009 [77 favorites]

Erm, what's the problem here? Unless she has been blood letting in your house the risk is almost non-existant. Get your kid tested if you're worried.

Whatever you do, don't make the poor babysitter feel worse because of your over-reaction.
posted by devnull at 4:15 AM on November 12, 2009

Yeah, casual contact isn't going to spread the virus.

Go here.

And the FAQ is here.

General questions here. Transmission information is here.

There is this little nugget in the transmission section: Although contact with blood and other body substances can occur in households, transmission of HIV is rare in this setting. A small number of transmission cases have been reported in which a person became infected with HIV as a result of contact with blood or other body secretions from an HIV-infected person in the household. For information on these cases refer to the May 20, 1994 Morbidity and Mortality Weekly Report, “Human Immunodeficiency Virus Transmission in Household Settings — United States.” Persons living with HIV and persons providing home care for those living with HIV should be fully educated and trained regarding appropriate infection-control procedures.
posted by cooker girl at 4:17 AM on November 12, 2009

You need to realize that you are already over-reacting. Take a deep breath. It's awfully hard to contract HIV. Casual contact won't spread it. Others have already provided good information about. The danger to your granddaughter is so tiny as to be virtually non-existent. If you are the type who like to worry, choking hazards and poorly adjusted car seat straps are way higher on the list of potentially lethal dangers than HIV exposure is.

I'm sure your son and daughter-in-law are going to handle this just fine.
posted by Pater Aletheias at 4:36 AM on November 12, 2009 [3 favorites]

First things first: take a deep breath. Unless the babysitter is sharing needles with the baby it highly unlikely that transmission will result. Seriously, unlikely in the same way that winning the lottery is ‘highly unlikely’.

Next, take a deep breath. Feeling better? Good. Now follow the CDC links above and educate yourself as to why HIV/AIDS isn’t a gay plague or divine retribution visited on the wicked for their sinful lifestyles, it is simply an autoimmune disease. No more, no less. People with both conditions go on to lead happy, productive and in many cases long lives – it’s not an instant death sentence.

Finally, - another deep breath - recognise that your reaction here is beside the point. This is for your son and his wife to react to. If they decide that babysitter should continue to mind baby – and with a few very basic precautions, there’s no reason why she shouldn’t – then you’re just going to have to lump it. If you start imposing your views on your son and his wife, it’s going to turn very ugly indeed, very quickly.

On preview: what Pater Aletheias just said,
posted by dmt at 4:55 AM on November 12, 2009

Response by poster: Thank you for your comments - I am a a little confused by some of the comments about overreacting - concern NEVER constitutes overracting. I came to Metafilter for advice and expertise BEFORE I gave my son and his wife my opinion OF COURSE it is there decision on what to do - but they asked and I am looking for guidance

To theichibun - as I stated she was only been diagnosed with HIV - not AIDS.

Many of you wrote such sincere comments that have given me the direction and expertise I want to convey to my son and daughter-in-law, thank you so much.

I do believe though that some of the trite comments were unnecessary - this was a heartfelt question and deserved a serious answer.
posted by pamspanda at 5:17 AM on November 12, 2009

I am a a little confused by some of the comments about overreacting

Well, your post starts with the word "DESPERATE!" and the "make matter worse" part didn't help either -- if she's a member of your extended family, shouldn't you be a bit concerned about her as well?
posted by effbot at 5:28 AM on November 12, 2009 [9 favorites]

Perhaps the concern should be more for the babysitter, as toddlers tend to be germy. But nevertheless, take a deep breath, grandma, and peruse those links. Your grandchild will be fine.
posted by St. Alia of the Bunnies at 5:49 AM on November 12, 2009 [11 favorites]

Best answer: To effbot - what made matters worse was that she was a member of the family and I did not want to do anything that would make her feel any worse. I am about as level headed as they come and would NEVER convey my concerns to my son unless they were founded. Obviously, they are not and that is the message I will pass on. With that said - my granddaughter comes first and I have to gather information and facts in order to make the right decision.
posted by pamspanda at 5:52 AM on November 12, 2009

There's totally a bit of a generational thing here, assuming you're normal grandmother-of-an-infant age. For those of us under the age of 35 or 40, this stuff has been around for our entire lives and, if you actually know someone with HIV, you know it's no longer anything like a death sentence. She'll probably be fine for _decades_.

People are incredibly sensitive about it, because there are tons of folks dealing with it. Just understand that some people are read your question as "help, my daughter is marrying a Chinese man!" or "help, I'm trying not to overreact, but my son's friend is gay."

The meds she'll be on will make the risk of passing the disease on to a child go from "as likely as as a plane crashing into your house" to "as likely as a green plane with purple stripes and a smurf on the side crashing into your house between noon and 12:15pm on a Thursday between Christmas and Easter."

COULD it happen? Yes. WILL it happen? I'd bet my child's life that it won't.
posted by paanta at 5:55 AM on November 12, 2009 [14 favorites]

One thing that others have not mentioned is the concern about how the babysitter became HIV positive and if that is a risk to the child. For example, did the babysitter become HIV positive because of sharing drug needles? If so, as a parent, that would cause me to question the person's ability to safely care for my child. I would not place my child in a known drug user's care. However, if the babysitter was not a drug user and became HIV positive after unprotected sex with someone met at a club, I would be much less likely to remove my child from their care.
posted by onhazier at 5:58 AM on November 12, 2009

Response by poster: To onhazier - than you for your sincere comments - just to let you know my best friend that was like a brother to me died of AIDS in 1991 - I was there with him every day and night in the hopsital - so I do know something about HIV and AIDS - but - when it is your grandchild there other concerns that I was not familiar with and I really appreciate all of the comments from Metafilter members that knew my concern was real and was for the welfare of my family - both parties. Thank you, again.
posted by pamspanda at 6:05 AM on November 12, 2009

Hi, pamspanda:

You say,

I am a a little confused by some of the comments about overreacting

Maybe I can help.

When a post starts with "DESPERATE!" and asks "What next????" with four question marks then concludes with "I need information and help before I jump out of my skin!!!!," ending in four exclamation points, the vast majority of readers are not going to think that you are

about as level headed as they come

They are, in fact, going to conclude that you are in desperation and about to jump out of your skin. Writing something like:

"My granddaughter's babysitter has just been diagnosed with HIV. What, if any, are the potential risks in this situation? The babysitter is also a family member, so I'm trying to be sensitive to her while I process this information."

would have done a better job of conveying your calm, level-headed sensibility.
posted by Pater Aletheias at 6:10 AM on November 12, 2009 [66 favorites]

Seriously, she's gonna be taking the same precautions as she would normally be taking. I'd be waaaaaaaaay more concerned about my non-hiv babysitter transmitting something like MRSA or the flu to my infant than I would be about someone with HIV. Heck, I'd almost bet she'll be significantly *cleaner* as she tries to protect her auto-immune self from sickness.

You got trite comments because you asked a question that made you sound haughty and ignorant, neither of which may be true to you.

You put the little bugger in a car seat, you take him to a pediatrician where brats with H1N1 have been sitting in the seats, you feed him processed irradiated baby food, bathe him with hydrocarbon extracts, wrap his butt in plastic, lay him on an off-gassing mattress, and you're going to freak out because the babysitter has HIV.

Your kids grew up in a world with things like measles and mumps and rubella and a thousand other things that were waaaaaay more transmissible than HIV.
posted by TomMelee at 6:11 AM on November 12, 2009 [1 favorite]

I am sorry you lost a loved one to AIDS. A dear friend of ours was HIV positive due to a blood transfusion when he was a kid. He sang at our wedding. He passed a few years ago from an unrelated medical issue. I totally would have trusted him to watch my son. He was a good person who took care of himself and his HIV status was never a concern to us.
posted by onhazier at 6:13 AM on November 12, 2009

I had a child die from a disease that was perhaps somewhere between "as likely as as a plane crashing into your house" and "as likely as a green plane with purple stripes and a smurf on the side crashing into your house between noon and 12:15pm on a Thursday between Christmas and Easter," using those phrases in the non-literal sense they were probably intended. I am explaining that only to put some context that you are hearing the thoughts of someone with an incredibly low risk tolerance when it comes to children.

I think an honest and frank discussion between the babysitter and the child's parents is in order, but I think it is one that takes the tone of understanding the risk of transmission is low and that the babysitter is not a pariah or comparable to a biblical leper. Talk about approaches to minimize transmission risk, how to handle if any emergency happens or bodily fluid (I am thinking of blood) is present, etc. There are emergency protocols now for suspected transmission to prevent infection, so all involved maybe should just get on the same page about what those are.

I think this can and should be courteously and kindly done. The babysitter is probably well aware of all of this information, but sharing it with the child's parents may help the child's parents (and grandparents) feel on firmer footing.
posted by bunnycup at 6:19 AM on November 12, 2009

Considering your own comment you gave Best Answer, I have no idea what you are asking. I think this may be true of all the other commenters are thinking. It seemed like you were panicking for no real reason and people tried to help allay that panic. But then your response is that you are not a panicky type of person and that you are well aware of the implications of HIV/AIDS.

So uh... what's your question again?

With that said - my granddaughter comes first and I have to gather information and facts in order to make the right decision.

What is the decision you are trying to make? Are you thinking of not letting her be a babysitter anymore? Is that your question?

If that's your question I would let your babysitter come to a decision on their own and support them on it. As others have pointed out, your granddaughter is actually a greater danger to the babysitter than vice versa.
posted by like_neon at 6:19 AM on November 12, 2009 [10 favorites]

It is possible that the babysitter might not want to work for you. She might have her own feelings on the matter as well as needing time and treatment to handle this. Just an alternative thought.
posted by stormpooper at 6:47 AM on November 12, 2009

Do state-approved daycare centers in your town allow workers with HIV? If they don't then I don't think you should either.

If they do allow it I am sure that they require the person to have training in how to not endanger others. At the very least your babysitter should have this training also or be able to pass a test proving she knows the facts about HIV. Or you could have a day where you serve brunch and everyone in the family and the babysitter goes over the training in a relaxed and friendly way.
posted by cda at 7:06 AM on November 12, 2009

Mod note: few comments removed - unless you can pretty calmly answer this question and/or be helpful, you need to go to metatalk or elsewhere, thanks and sorry.
posted by jessamyn (staff) at 7:08 AM on November 12, 2009

I can kind of understand why you're worried - perhaps, as you know about AIDS from experience, you're worried about your toddler perhaps getting a cut, or blood being spilt whilst chopping up carrots.

Do you know any long-term sufferers you can speak to - as posters above have said your babysitter will not have come to terms with this yet. Some doctors have HIV and are allowed to continue practising, and that involves as much bodily contact as a babysitter would have.

Ultimately, yes, it is up to you on whether you feel 'safe' employing her still. But bear in mind that all HIV is is an auto-immune disorder, and if you fire her for having HIV then it will seem as though you are acting with prejudice toward those with disabilities...which may be why some posters are feeling hostile here. HIV isn't the bogeyman that older people think it is - it strikes all kind of people through all types of ways. There's no such thing as 'good HIV' and 'bad HIV', and if you speak to the family, you need to stress that your concern is around risk to your child and risk only. Your reaction here reminds me of Arthur Fowler in EastEnders..
posted by mippy at 7:19 AM on November 12, 2009

I think right now she is seeing this thru the screen of GRANDMOTHER along with her personal experience of just how devastating a disease this can be. I'm a grandma too so I understand.

Let's help her take that deep breath and look at the facts calmly, shall we? I think cda probably has the right angle. But again, if I were the babysitter, I might think hard about being around a germy young child.
posted by St. Alia of the Bunnies at 7:22 AM on November 12, 2009

I don't see the problem here. Your babysitter should not be exchanging bodily fluids with your child to begin with. I understand the impulse to freak out, it's a scary disease, but when you think of actual risk factors for contracting HIV - sex, sharing needles, blood transfusions - none of those will be happening between a childcare provider and a child.

Do state-approved daycare centers in your town allow workers with HIV? If they don't then I don't think you should either.

I've worked for daycare centers (state approved in RI) and they are not allowed to ask about medical history beyond requiring proof of vaccination and a TB test. For them to ask about HIV would be illegal. So, your child could have an HIV+ care provider and you would never know.

If they do allow it I am sure that they require the person to have training in how to not endanger others. At the very least your babysitter should have this training also or be able to pass a test proving she knows the facts about HIV. Or you could have a day where you serve brunch and everyone in the family and the babysitter goes over the training in a relaxed and friendly way.

No, they don't. They do not require that employees provide medical information and if such information is disclosed voluntarily by the employee, the center is not legally permitted to act on that information in any way that would be discriminatory. Any "training" would be center wide and frankly, un-necessary since daycare workers are required to do first-aid training which covers BSI precautions. Putting the babysitter in a situation like this would be insulting and stressful for her - if you really want to be sure she's gone over transmission risk, simply ask that she take a first aid course. That will cover anything she needs to know since the FIRST THING they go over is scene safety - including risks from bodily fluids.
posted by grapefruitmoon at 7:49 AM on November 12, 2009 [3 favorites]

I'm sure your reaction is informed by your experience caring for your friend, which sounds like it was very painful for you. It may offer you some comfort to know that the development of drugs over the last fifteen years means that many people who are HIV+ live long and healthy lives.

If it helps, think of it as being somewhat like Type 1 Diabetes - a potentially life-threatening condition that can be controlled by drugs, which is, as other posters have noted, highly unlikely to be passed on to your granddaughter.
posted by featherboa at 8:07 AM on November 12, 2009

It doesn't sound like you have any plans to see her fired at this point (fortunately), but I will point out that firing people because of their HIV status has generally been seen as illegal under most circumstances. I don't see any cases particularly involving a babysitter, but there have been a number involving medical professionals (a dental hygienist is one that comes up in the above link), so I find it unlikely that the EEOC would be particularly sympathetic. IANAL of course, and you/her parents should be consulting an employment lawyer before doing anything that looks like a step downwards in her employment status over this.

Now, your baby will be just fine, as everyone above points out. I don't know whether we're talking about an occasional babysitter or a full-time nanny, but if this is someone your son employs full-time or even less than that, my concern would be whether the babysitter has health insurance, and if not, how she is going to get the health care she needs. (I'm assuming you are in the US; ignore me if this is not an issue where you are.) Getting a policy for a nanny can be tricky, especially now that she has a pre-existing condition, but I bet she would appreciate you guys offering to research options for her and, if possible, covering a portion of her premiums. As I understand it, employer-provided health insurance is tax-deductible to the full amount of the premium (even if the employer only pays a share), while individual insurance isn't deductible at all.
posted by zachlipton at 8:16 AM on November 12, 2009

I'm going to suggest that you rephrase the question and give us another shot at answering. It's not clear at all what your question is. Over what are you about to "jump out of your skin"? If you've dealt with someone dying of AIDS before, then presumably you know about the risks and non-risks of having an HIV-positive person around. Seriously, what do you need help with? Finding support resources? Understanding how to talk to her? Getting the latest information on anti-retroviral drugs? What? Why are you DESPERATE?
posted by Dasein at 8:19 AM on November 12, 2009 [4 favorites]

Nthing paanta. AskMe is for answers, not giving reasons the poster's thoughts/opinions aren't a problem. The poster was quite clear that she was venting, and giving her thoughts on the matter while acknowledging she didn't have all the facts.
posted by variella at 8:19 AM on November 12, 2009

featherboa: In fairness, Diabetes isn't remotely contagious, while HIV, in fact, is. The possibility of transmission is very slight, but the analogy really doesn't apply.

If it makes you feel better though, with modern medication, having unprotected sex with an infected person taking an appropriate cocktail of drugs (and taking them on time and daily) has a rather low rate of transmission. If that can happen without passing on HIV, surely normal babysitter stuff has a risk so small as to be negligible, which is why employees now have no duty to even disclose this and employers cannot fire them for it if they do.
posted by zachlipton at 8:24 AM on November 12, 2009

Getting a policy for a nanny can be tricky,

I'm a nanny with a pre-existing health condition (we do exist!) and I buy my own insurance. I pay through the nose for it and it was hellishly difficult to set it up, but I'd be happy to answer any questions about how I worked it out if this is an issue for your family.
posted by grapefruitmoon at 8:35 AM on November 12, 2009

How do we handle this situation?

Ensure that all stakeholders in this situation are well informed about the realities of HIV. Ensure that no one starts panicking, pointing fingers, or going on a witch hunt. If your family is comfortable with having a baby-sitter who is HIV positive, continue as usual. If not, get a new babysitter. Once you ensure that everyone is cool and the baby is being baby-sat, focus your attention on the HIV positive baby-sitter and give her all the support she needs.
posted by jasondigitized at 8:40 AM on November 12, 2009

You have nothing to worry about as far as the baby goes. The babysitter, your family member, could probably use some kindness and understanding though.
posted by Jess the Mess at 9:01 AM on November 12, 2009 [1 favorite]

Have you spoken to your son and daughter-in-law? What's their take on the situation?
posted by mippy at 9:31 AM on November 12, 2009

Mod note: Folks, metacommentary about best answers and such really needs to not take place in here.
posted by cortex (staff) at 10:17 AM on November 12, 2009

jasondigitized: "Get a new babysitter" is most likely not an option unless there are other problems with the babysitter's performance that we don't know about. Firing someone because of a medical condition when that condition in no way puts anybody at a non-negligible risk for harm and has no effect on that individual's job performance is generally illegal and most always immoral. Being "uncomfortable" with someone's HIV status is not grounds to fire her.
posted by zachlipton at 10:36 AM on November 12, 2009

Did you google how HIV is transmitted before posting this question? Because information about HIV and AIDS is very easily googleable. This is the first page that comes up when I google it. If there is other information that you're seeking with this question, I am not clear what it is.
posted by amro at 11:05 AM on November 12, 2009

2nd/nthing that this situation may be more risky for the nanny than the baby because if she has a compromised immune system, the last thing she needs to be around is a germy little kid (no offense to your grandkid, all little kids are germy).

I don't really know what your actual question is, but an actual real suggestion I would give is for your son and daughter-in-law to talk to their pediatrician about any concerns. I'm sure the doctor could give some informed and reasoned advice.

If you legitimately are as not-freaking out as you say you are in your follow-up comments, it may just be that the way you type doesn't reflect that properly. The use of caps and exclamation points, as well as the phrasing really sets a tone of panic in your post. Obviously as a grandmother, you were once a parent of young kids, and think about how you may have felt about your own mom/mother-in-law freaking out about news you gave them. My grandmother is a chronic over-reactor, so my mom just stopped telling her things a lot of the time, and growing up we had to learn to censor things to keep grandmom from freaking out. Presumably, you don't want that to happen, so approaching them about this calmly is probably to everyone's benefit.
posted by ishotjr at 12:58 PM on November 12, 2009

I guess I didn't think about firing the babysitter because she was most likely never formally hired and 'HR' wouldn't be getting involved. If my kid was 'uncomfortable' with my babysitter because she was just 'uncomfortable', I would be letting said babysitter go.
posted by jasondigitized at 2:24 PM on November 12, 2009

educate yourself as much as possible on the issue, and then make the decision that you feel comfortable with having learned everything you can on the issue. that will be the right decision.
posted by saraindc at 7:42 PM on November 12, 2009

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