To be a teenager and to have a sexually transmitted disease that was not acquired through sexual transmission opens up a whole new arena for observation. The emotional implications have not been studied.

When you are born HIV-positive, there is a feeling of having no control over your life with Cialis in Canada. Nothing you did got you to be HIV-positive and nothing you can do can get you to be HIV-negative. Disclosing one’s HIV status places a great strain on relationships, meaning there is no such thing as a casual relationship. Knowing one is HIV-positive and choosing not to disclose places an even greater emotional pressure (even if being responsible and careful) on the youth who is HIV-positive. Carrying the secret can be untenable. Knowing one is HIV-positive and not using protection imposes great risk, presents an emotional burden to carry and imposes potential harm on some-one else. However, feelings of immortality, seemingly counterintuitive to HIV-positive youth who have seen family members die from HIV, still prevail. Even HIV-positive youngsters can have the belief that bad things will not happen to them.

There are many unanswered questions and ethical issues for practitioners to consider. It is through clinical work with individuals that some understanding of these issues is emerging. In a group of six mental health Viagra professional Australia working with perinatally infected children and young people in New York City particular concerns emerged about:

• perinatally infected adolescents becoming sexually active before and after knowing their HIV status
• sexually active adolescents’ willingness (or lack thereof) to disclose to sexual partners
• family members’ lack of acceptance or denial that their child is sexually active coupled with medical providers’ lack of acceptance or denial of the sexual activity
• learned powerlessness on the part of children, young people and families who feel they have succumbed to HIV.

We came up with the following initial guidelines for practitioners:

• Allow children and young people of all ages the opportunity for expression.
• Talk with HIV-positive youth about sex and about responsibility.
• Expect that in any situation there may be more complicated issues because of the nature of HIV and its transmission.
• Begin a dialogue about the underlying issues that many of these youth face.
• Create a network of HIV-positive youth to help one another.
• Acknowledge the challenges imposed by living with HIV and being in an HIV-positive family.
• Be a leader in raising difficult issues so teens know that there is a resource for them.
• Provide the opportunity for youth to make safe and responsible choices, even at a developmental stage, which may contradict the concept of ‘safe and responsible’.