Article States That HIV-Infected Adults Need Family-Centered Support

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A large proportion of HIV-infected adults have children under the age of 18, and these adults should have access to family-centered support services, according to a study published in the American Journal of Public Health. Twenty-eight percent of infected adults surveyed in the national HIV Cost and Services Utilization Study (conducted in 1996 and early 1997) had at least one child under the age of 18. The authors state that the actual percentage is even higher, since the study excluded infected parents with no health care and those who received care in prisons, military facilities, and emergency rooms.

The study was based on a multiple-stage national probability sampling of adults with known HIV in both metropolitan and rural areas. Among the study’s findings are the following:

• 53% of the respondents with children had more than one child, 29% had two, 14% had three, and 10% had four or more.
• Among the respondents with children, 16% had children ages 0 to 2; 24% had children ages 3 to 5; 59% had children ages 6 to 12; and 45% had children ages 13 to 17.
• 12% of women and 2% of men had conceived a child after being diagnosed with HIV (i.e., the child was born 10 or more months after diagnosis).
• 10% of women and 1% of men had a child who was born after diagnosis but probably conceived before.
• Among the children of respondents, 52% lived with the respondent, and 28% lived with their other parent, for a total of 80% living with at least one parent. The remaining children lived with a grandmother, another relative, or an unrelated foster or adoptive parent, or in another setting such as a group home.

Many HIV-infected parents in the study were at a relatively advanced stage of illness, which likely affected their ability to care for their children. Sixty percent of parents living with their children had symptomatic HIV, 30% had AIDS, and 21% had been hospitalized during the previous 6 months. The data also showed that 17% lacked health insurance, 19% put off going to the doctor because they were too sick, and 20% had needed to find a place to live in the previous 6 months.

The authors state that "because it is reasonable to consider the minor children of HIV-infected parents as part of the HIV-affected population, this indicates a much larger disease burden than has been commonly recognized." They conclude that "any planning for the future of the epidemic will need to consider the impact on parents of having responsibility for children and the impact on children of having parents with a chronic, stigmatizing, and potentially fatal condition." Systems of care that address HIV-affected families' needs (including medical care, supervision, counseling services, child-care provisions, and financial support) will best serve those families affected by the HIV/AIDS epidemic.

Schuster MA et al. 2000. HIV-infected parents and their children in the United States. American Journal of Public Health 90(7):1074-1081.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.