Source: Washington Post
For nearly a quarter-century they have come to the first floor of Children's Hospital: teenagers infected through circumstances, always tragic, or through choices, admittedly bad ones. More than 30 new cases in 2007 alone, as the epidemic that is HIV and AIDS extended its reach through a second generation of adolescents.

Fears of ostracism have kept them largely silent elsewhere. As patients, however, they've been urged to talk. Not just about their pasts, but about living and dying and coping with the possibilities of both.

Encouragement was all they needed.

"Before I told anyone, I felt like I was in a box," one teen says. "I couldn't sleep. I was like, 'Who can I tell?' "

These are the voices that psychologist Maureen Lyon and physician Lawrence D'Angelo have woven into "Teenagers, HIV, and AIDS," perhaps the first text on the subject to place young people, in prose and even poetry, alongside the experts. It is a true collaboration, one that gets and gives plain-talk advice.

Lyon and D'Angelo explained their rationale in the book's dedication, a tribute to the more than 400 HIV-positive patients for whom they and others on the Children's staff have cared.

With new infections occurring with increasing frequency among 13- to 19-year-olds, thousands of adolescents across the country are receiving diagnoses every year. The shattering results must be followed by compassion and very tailored conversation, according to the book, for every aspect of HIV can be different in these cases, from the virus's progress in the body to the services available to a suffering teenager.

The book, available online and in stores, addresses the host of medical, treatment, disclosure and support issues. Beyond teens, it's aimed at health-care providers, who often don't listen well to adolescents; at school leaders, who in many systems still provide minimal education on sexually transmitted diseases; and, of course, at parents. Over the years, both Lyon and D'Angelo have comforted teens who've been kicked out of their homes after telling their families.

The arc of the disease is reflected in Children's current patients. Three-fifths were born to infected mothers, a proportion that is waning because of the availability of medications to block any viral transmission during and after delivery. The remainder, both male and female, put themselves at risk through sexual behavior. And the makeup of that group is shifting: Girls have gotten smarter, and safer, whereas HIV among gay males is rising dramatically.

Carl, a 19-year old HIV-positive college student, spoke with Washington Post reporter Susan Levine for the newspaper's series, "A Living HIV Quilt":

"Over the past two years, I've grown a lot," he said. "I've become educated, I've become educated on the subject through my doctors, my social workers. . . . I've really become one with who I am, and I've embraced being HIV-positive. Sometimes I even forget I have it. I live a normal life. Like I say, I'm a college student. I have normal bills, normal student loans. . . . I live a life of a teenager.

"Teenagers start rumors. So I had rumors from everywhere: I was starving my soul. I was bulimic. And then the big thing came out: Everyone said Carl had AIDS. The big rumor came out about Carl having AIDS.

"I used to have pity parties for myself. You know, that was the hardest part. I would have a weekly pity party, where I would go and I would sob and it would be sob, play the blame game, feel sorry for myself. I don't have those anymore.

"I've changed my sexual patterns and my sexual behavior, um, where at first I was afraid to ask for condoms.

"I use them, I'm not afraid to use them.

To me, it's a part of you. It's like anything that's a part of you, from a scar on your hand . . . it's something you have to live with. It's something you have to say to yourself: 'Am I gonna let this scar on my face control who I am as a person? Am I gonna let cancer dictate my life?'"

Full article: Teen Voices of AIDS - washingtonpost.com
A Young Man Learns to 'Embrace' His HIV Status | Washington Post