The administrators, doctors, nurses and volunteers act like surrogate parents, adopted big brothers and sisters — and sometimes whipping posts for the children, who come to the center from foster care, when their parents grow too ill to care for them, or when they are orphaned.
ICC officials are allowing their kids, led by Lady X, to go on closely supervised dates with a strict curfew. Administrators say they are planning to deal with dating requests on a case-by-case basis. They are also allowing them to have friends visit the center on weekends — with permission and advance notice. And the children's parents, when they have them, are always consulted.
"This [dating] is something we've really struggled with," said Carolyn Castro, executive director of ICC. "We very much want to make this a homelike environment. We've never done anything like this before. We set up a time limit, age limit, all the types of things you'd find in a family situation."
And ICC administrators stress that their children do participate in school events like parties and junior proms, enjoying events that their classmates may take for granted.
"They go through your normal everyday teen issues, like everyone else," said Dr. Margaret Heagarty, a longtime physician at ICC. "Sometimes they're 2 years old, sometimes they act like they're 22. They're really your normal teenagers."
Soon, they will be going through adult issues, too, and no one is really sure what that will mean.
In an article for February's American Journal of Public Health, Dr. Stephen Nicholas, director of pediatrics at Harlem Hospital Center and a co-founder of ICC, called the especially troubled population of children born HIV-positive growing into teenagers a "new crop of 'boarder babies,'" some of whom are being rejected by adoptive parents who were surprised at how long they have lived and were not prepared to deal with their various problems. Nicholas warned that there were no ideal settings to address all these children's needs and that some are destined to end up in the juvenile justice system.
And no one really even knows how many children are about to come of age.
The Centers for Disease Control and Prevention estimates that in the early 1990s, about 1,000 to 2,000 infants were born with HIV each year, and that between 1992 and 1998, perinatal HIV cases (HIV cases manifesting in the months before or immediately after birth) dropped 75 percent. But they are not sure how many of those children lived.
In its most recent statistics, the CDC says they know of 8,207 children under the age of 13 diagnosed with HIV/AIDS who have mothers who were also HIV-positive or were at risk. But CDC officials say they do not have an exact number on how many children have reached or are approaching their teens. Some cases simply are not reported to the government. And some children were not diagnosed with the disease right away.
Caregivers are all too familiar with the severe mental and behavioral problems encountered with some children. The mothers of many of these children abused drugs while they were pregnant, and experts are not sure how much parental drug abuse affected child development.