Under the category of infectious diseases, HIV/AIDS has been labeled as a global epidemic since the early 1980s. Well into the 21st century, researchers faced numerous challenges in developing treatments, let alone cures, for the virus. However, after four decades of scientific and clinical devotion, medications have been developed to ensure those infected can lead long and healthy lives.
HIV, short for human immunodeficiency virus, attaches to the body’s CD4 T-cells, impacting the ability to fight infection. If the virus goes untreated, it can overtake the body’s T-cells and lead to a diagnosis of AIDS (acquired immunodeficiency syndrome). Once diagnosed with AIDS, a person with HIV is unable to fight off illnesses such as the common cold.
HIV is known to spread through blood contact, most commonly by human-to-human sexual contact and needle use in adults. However, the virus is prevalent in the pediatric world as well. Alka Khaitan, MD, is an associate professor of clinical pediatrics at the IU School of Medicine who has dedicated her medical career to pediatric infectious diseases. She said that she always intended to work with children but was drawn to the subspecialty of infectious diseases and global health due to its focus on the entirety of the body and the microbiology that comes into play.
“What led me to HIV research is the importance of the global health platform, and that meant locally, internationally and globally,” Khaitan said. “I wanted to be able to do all facets of that work.”
Khaitan provides care to pediatric patients at Riley Children’s Health, and essential research at two sites in Kenya — Bomu Hospital in Mombasa, and Moi University on the border of Eldoret.
At the IU School of Medicine, she is also a researcher with the Herman B Wells Center for Pediatric Research and the Ryan White Center for Pediatric Infectious Diseases.
In the mid-1980s, Indiana native and Riley Children’s patient Ryan White gained international attention after becoming one of the first children to publicly speak about his HIV infection, which he contracted from a contaminated blood transfusion used to treat his genetic bleeding disorder, hemophilia. White and his family became prominent HIV-awareness advocates after he was banned from attending classes due to the stigma of his diagnosis.
In 1988, White delivered a testimony before the White House where he spoke on the social hardships he faced during his time at school.
“Rumors of sneezing, kissing, tears, sweat and saliva spreading AIDS caused people to panic,” White said. "Because of the lack of education on AIDS, discrimination, fear, panic and lies surrounded me.”
White passed away in April 1990, and 2025 marked the 35th anniversary of his death. The Ryan White Center for Infectious Diseases continues to honor White by fighting pediatric infectious diseases.
“Ryan White’s legacy continues to shape and inspire our division, as well as HIV and AIDS care and research across the nation,” Khaitan shared. “It is a privilege to be part of the Ryan White Center, where we honor his memory through our commitment to providing compassionate, comprehensive care for children of all backgrounds and to reducing the stigma surrounding HIV. By carrying his memory forward, we strive to ensure that future generations never forget the profound impact he made.”
As researchers are diligently trying to find a cure for HIV, preventing the spread of the disease remains critical, but stopping the spread of misinformation is also top of mind.
“I think education and reducing the stigma would be amazing ways to reduce the spread,” Khaitan said.
To clarify some of the most pressing questions about HIV in the pediatric community, Khaitan addressed several misconceptions and facts about the disease.
HIV facts vs. myths
Fact or myth?: Like the herpes virus, HIV can be contracted by drinking after someone with the virus.
Khaitan: Myth. HIV can be spread from one person to another, and the main way is through blood or sexual fluids. Saliva is not one of those ways that can pass HIV. You cannot spread HIV by kissing, sharing utensils or drinking from the same glass.
Fact or myth?: If I am diagnosed with HIV, I will have to take a bunch of medicine every day for the rest of my life.
Khaitan: Fact. There is no cure for HIV, and so in order to keep the virus suppressed and maintain a healthy life, you need to take the medication. It’s actually three medications that are combined into one pill that you need to take for the rest of your life. But if you do that, you can live a long and healthy life. You can have children without HIV; you can choose to breastfeed. So really, you do not need to be limited, but you do need that medicine.
Fact or myth?: Once a person has HIV, they will have to avoid hugging and kissing forever.
Khaitan: Myth. Please hug. Please kiss. You cannot pass HIV that way. These were all the misconceived notions of why Ryan White was so stigmatized. People didn’t want him in their schools. They were afraid to be around him because they thought they could get HIV just by being around him. So, this is an absolute myth.
Fact or myth?: Children can only contract the virus through their parents.
Khaitan: Myth. So, in young children, that is typically how we think they may have acquired HIV, through vertical transmission (born with it or through breast milk). However, we do know some children who have acquired HIV in other ways. Sexual abuse, unfortunately, is a reality. Before we started screening our blood in the U.S., we used blood transfusions. In the 80s and 90s, that did happen. And then IV drug use or sex, especially in adolescent children, is a way that HIV can be acquired. Unfortunately, in Indiana, we have been seeing a rise in new HIV infections in adolescents, and we think most of that has been sexually acquired.
Fact or myth?: There is a cure for HIV.
Khaitan: Myth. However, the most remarkable thing that I’m excited about in the HIV world is talk about a cure. When I started my career in HIV, it wasn’t even thought to be ever possible or achievable. Recently, we’ve had a few cure cases, and now there’s a whole cure agenda in the research world. So, we don’t have a cure, but just having people working toward that goal is huge and sheds some light of hope for the future.
As of July 2025, there have been 10 cure cases. The specifics of each treatment that led to the cures vary widely and do not replicate evenly across different patients, and none have occurred in the pediatric world.
In 2010, an infant with HIV known as the “Mississippi Baby” was born to a mother living with HIV who had not received prenatal treatment. Within about 30 hours of birth, clinicians began a three-drug antiretroviral regimen, far earlier than standard practice at the time. The child was confirmed to be living with HIV and remained on treatment until approximately 18 months of age, when she was lost to follow-up, and therapy stopped. When she returned to care about five months later, standard testing revealed no detectable virus and no HIV antibodies. Remarkably, she remained off medication for a total of 27 months while maintaining undetectable viral levels, but in July 2014, at nearly 4 years old, the virus reappeared and treatment was restarted. Although the child did not achieve a cure, the case remains historically significant because it demonstrated that extremely early therapy can suppress HIV so profoundly that the virus may remain undetectable for years, offering unprecedented insight and hope for future research into sustained remission and potential cure strategies in infants.
Another treatment that is being used with pediatric HIV patients is the use of BNABs (Broadly Neutralizing Antibodies). BNABs are antibodies that bind to HIV and neutralize the virus. Researchers are analyzing the different types of antibodies to see if they can be used as an adjunct to get to a cure. So, there’s a big cure agenda in the pediatric HIV world along with the adult HIV world, and the strategies are different because the transmission is happening in different ways.
The fight continues
Although the effects of HIV infection are still being felt around the world, researchers like Khaitan are devoted to educating the masses about how to prevent the spread, providing the best medicines to support long and happy lives to those infected, and eventually, finding a cure for HIV and AIDS.
