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APHA Scientific Session and Event Listing

Burton O. Cowgill, MPH¹, Megan K. Beckett, PhD², Rosalie Corona, PhD³, Marc N. Elliott, PhD⁴, Michelle Parra, PhD⁵, Annie Jie Zhou, MS², and Mark A. Schuster, MD, PhD⁶. (1) UCLA/RAND Center for Adolescent Health Promotion, 1072 Gayley Avenue, Los Angeles, CA 90024, (310)794-3567, bcowgill@ucla.edu, (2) RAND, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, (3) Virginia Commonwealth University, 808 West Franklin Street, Richmond, VA 23284, (4) Rand Corporation, 1776 Main Street, Santa Monica, CA 90407, (5) Los Angeles County Department of Health Services, 3530 Wilshire Boulevard, Suite 800, Los Angeles, CA 90010, (6) RAND, UCLA Departments of Pediatrics and Health Services, 1072 Gayley Avenue, Los Angeles, CA 90024

Background: HIV-infected parents generally face the challenge of caring for their children while coping with a chronic illness that may lead to their incapacitation or death. Parents may find planning for the future care of their children to be a difficult process because they must identify a suitable guardian and navigate the legal system while managing their own illness. Past studies on guardianship planning for HIV-infected parents have mostly been limited to convenience samples in large cities. Therefore, we used nationally representative data to describe guardianship planning for children of HIV-infected parents. Methods: We used 1996-98 data from the HIV Cost and Services Utilization Study (HCSUS), which interviewed a national probability sample of adults with known HIV infection in the contiguous U.S. Our sample includes 192 unmarried HIV-infected parents who report on the 325 children in their custody. We conducted bivariate and ordered logistic regression analyses that accounted for clustering of children within families. Results: Unmarried HIV-infected parents had not identified a guardian for 15% of the children; for 7% of children, the parent had identified a guardian, but had gone no further; for 51% of children, a guardian had agreed; and legal documentation had been prepared for 28% of children. Grandparents and other relatives were the preferred guardians. The guardianship planning process is most complete for children of parents with the lowest CD4 counts and those living without other adults. Conclusions: Clinicians and others who treat HIV-infected parents may be able to provide counseling and referrals for guardianship planning.

Learning Objectives: At the conclusion of the session, the participants in this session will be able to

• Articulate the steps in the guardianship planning process for HIV-infected parents.
• Describe the percentage of HIV-infected parents completing each step of the guardianship planning process in the United States.
• Identify characteristics of HIV-infected parents that put them at risk for not completing the guardianship planning process.

Keywords: HIV/AIDS,

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 775.5 kb)