This 2005 article about the changing experience of HIV+ adolescents includes quotes from Sheila:

”This is not like cancer,” says Sheila Ryan, program director of the Special Needs Clinic at Columbia-Presbyterian. ”These families are not a cross-section of the population. These issues would be agonizing for any family to deal with, but the families that are likely to be dealing with H.I.V. are more likely to have problems with substance abuse and mental illness. These are poor families, and even within the poor community more likely to be fragile than others on the same block.” …

”The two issues they keep coming back to,” Sheila Ryan of Columbia-Presbyterian says, ”are the permanence of the virus — the idea that there’s nothing you can do to get rid of it — and what kind of impact it will have on their capacity to have children, which is partly a question about the ways in which they might be impaired or maimed or less than others.”

”Sometimes kids find ways of protecting themselves from the information,” Ryan adds. ”One girl who was in here, at the time we finally said the word H.I.V., she said, ‘But I know I don’t have AIDS.’ I said, ‘How’d you figure that out?’ And she said, ‘Because if you have AIDS, you’re skinny and living in Africa, so I know I don’t have it.’ Or another girl who was 15 — her mother told her the week before she came in here for the first time, and her response to that was simply that her mother had lied to her.”

— From “Their Unexpected Adolescence“, by Jonathan Dee, New York Times, June 26, 2005