Many children of HIV-positive parents are not in their custody

A new joint study by UCLA and the Rand Corp. shows that more than half of children with an HIV-infected parent are not consistently in that parent's custody.

Researchers found that during the two-year study period, 42 percent of children were not in the HIV-infected parent's custody at any time.

The research is the first to use data from a nationally representative sample of people in care for HIV infection to investigate the custody status of children. The findings will be presented at the annual meeting of the Pediatric Academic Societies in Toronto on May 7.

"Children of HIV-infected parents are at risk for behavioral and emotional problems. A stable home may help these children and their parents cope with the effects of HIV on the family," said lead author Burt Cowgill, M.P.H., a doctoral candidate in the department of health services at the UCLA School of Public Health and a researcher at the UCLA/Rand Center for Adolescent Health Promotion. "By understanding whether children of HIV-infected parents remain in their parent's custody, pediatricians and other physicians may be able to help families address custody issues and offer referrals to social services."

Cowgill added that pediatricians may also want to suggest that HIV-infected parents include future custodians in their children's doctor visits so that these individuals are familiar with the physical and mental health needs of the children.

Using data from the Rand Corp.'s HIV Cost and Services Utilization Study, the team investigated whether HIV-infected parents had maintained custody of their children during the two-year period from 1996 to 1998. They found that 47 percent of children remained in the custody of an HIV-infected parent, while 42 percent were not in the parent's custody at any time. The remaining 11 percent were out of their parent's custody at some time during the study period.

HIV-infected fathers, parents with more advanced HIV disease, drug-using parents and parents with at least one hospital stay were less likely to have custody of their children.

A child's other biological parent or other family members (grandparents, aunts/uncles) were most likely to be the alternate custodian. Parents cited drug use (62 percent) and financial hardship (27 percent) most often as reasons for losing custody of their children. Only 10 percent of HIV-infected parents mentioned the effects of HIV/AIDS as a reason for not maintaining custody of their children.

"Improved treatments for HIV have enabled many HIV-infected parents to live longer. Parents continue to face obstacles that can affect their ability to maintain custody of their children, including financial hardship, ongoing drug use, and the effects of HIV/AIDS and medications used during treatment," said the study's primary investigator, Dr. Mark Schuster, professor of pediatrics and public health at the David Geffen School of Medicine at UCLA and director of health promotion and disease prevention at RAND.