The Chicago home shared by Terri Smith and her husband, Brad Roback, boasts the sort of organized chaos so typical of families with a toddler. Terri sits at the kitchen table with their 18-month-old daughter, Sachi, sharing puréed-squash soup. Clad in a giraffe bib and multicolored knit booties, Sachi peers up at her mom with huge brown eyes, angling for a spoonful. "Hey, Toots!" Brad proclaims as he walks into the room, kissing his daughter on the forehead. Their home is an eclectic mix of modern orange and aqua furniture, black-and-white family portraits, a rainbow of mismatched plates and goblets nearly tumbling out of a built-in hutch, and an armada of stuffed animals lining the floor.
Upon closer inspection though, a key detail emerges, suggesting this household is a bit different: In the kitchen, a cluster of syringes and bottles stand poised for Sachi's evening medication ritual. Soon, Brad will set about filling one needleless syringe with a bitter-tasting but lifesaving HIV drug called Kaletra; a second syringe holds maple syrup, to sweeten Sachi's mouth immediately post-squirt. The entire process takes about a minute, and after a brief struggle, Sachi is happily sucking on a bottle of milk that contains AZT and Epivir, two more powerful antiretrovirals. Except for the raspy coughing of their dog Boutros, the room is peaceful. A statue of Ganesh—a jolly Indian deity with the head of an elephant, known as the Remover of Obstacles—looks over from the hallway, smiling.
There are 2 million children like Sachi worldwide—living with HIV, a retrovirus that had for years been considered a death sentence, and often still is in places like Haiti, Vietnam, Ethiopia, and India. But thanks to a small but growing group of would-be parents looking to bring a child into their homes and lives, and the increasing manageability of HIV in areas with access to medical care, they're finding homes...and thriving.
While no hard numbers exist for HIV adoption, the field is growing by "leaps and bounds," says Erin Henderson, the coordinator for HIV-positive kids at Adoption Advocates International (AAI) in Port Angeles, WA. In 2005 AAI helped two HIV-positive Ethiopian children come to the U.S.; in October 2009 the agency had 45 such adoptions in process or completed.
The fact is, science and medicine have come so far that "we would rather treat pediatric HIV than juvenile diabetes," says Kenneth Alexander, M.D., chief of pediatric infectious diseases at the University of Chicago. "If you look at how well our medications work, there's no reason not to expect that Sachi will one day see her grandchildren."