DCFS Policy Testing a child in foster care requires the consent of a parent or the DCFS Guardian.  The Guardian’s consent may be obtained through DCFS’ authorized agents. DCFS must have temporary custody or guardianship to authorize testing. HIV testing should be encouraged as a matt er of routine health care when any of the following risk factors are present:

• a child with HIV-related symptoms; 
• a child born to a parent with HIV;
• a child born to a parent with a history of drug use, transfusions, or multiple sexual partners;
• a child who is sexually abused;
• a child born with positive drug toxicology;
• a child born with positive drug toxicology;
• a child born with positive drug toxicology;
• a child born with positive drug toxicology;
• a child for whom a complete medical history cannot be obtained.

Child’s Right to Consent 

Any child over age 12 may consent to testing.  Pre- and post-test counseling should be provided. Treatment requires the consent of the guardian or authorized agent.  

Physician’s Right to Test 

A physician may test a patient without consent in order to provide appropriate diagnosis and treatment. The physician should, however, provide counseling and inform the guardian. 

Symptoms Suggesting Testing May Be Needed 

Talk to the child’s HealthWorks primary care physician and the caseworker if your preteen or teen is or may be using drugs or alcohol, or is or may be involved in risky sexual behaviors. He or she may be at higher risk of HIV infection. 

Symptoms suggesting a need for HIV testing include:

• persistent fevers; 
• poor weight gain or rapid weight loss; 
• frequent diarrhea; 
• recurring or unusual infections; 
• chronic lymph node swelling; 
• persistent or recurring extreme tiredness or lethargy; 
• white spots in the mouth; and   
• loss of appetite. 

Caregivers may also get confidential information and advice from the DCFS AIDS Project (See page 34) about working with any child/youth who may be at risk of HIV and AIDS. 

Caregivers Have a Need to Know About HIV Test Results 

If DCFS knows of a child’s exposure to HIV or HIV infection, the DCFS AIDS Project should be notified immediately. Additionally, the caseworker should tell the caregiver about the child’s status prior to placement in order to prepare the family to make an informed decision about taking care of the child. 

The realities of foster care are that sometimes, initially, the history is unknown until after the child is placed into the foster home. In this case, foster families may be notified of the child’s HIV status aft er the fact. In either case, the AIDS Project would provide training and on-going support services about HIV issues.

Babies Under 18 Months Old 

Caregivers taking a baby under 18 months old should ask the caseworker if the baby has been tested for HIV. Children under 18 months who are known to have been exposed to HIV are followed by a qualified HIV clinic for further diagnosis and treatment. The AIDS Project will help make this linkage. 

Studies have shown that the majority of children exposed to HIV in their mother’s womb, or at the time of birth, have not contracted the HIV virus. New protocols for delivering and treating the baby and the mother have reduced the national perinatal infection rate from 25 percent to just 2 percent. Many babies who initially test positive in infancy lose their mother’s antibodies and will test negative by 18 months because they are not infected. 

Adolescents  

More of the infected children in foster care will be of adolescent age. Youth 12 and older should be included in the decision to test for HIV according to the risk factors. Youth 12 and older should also be consulted about any disclosure of their HIV status and consent should be sought for the release of information.