MENTAL-HEALTH ISSUES IN HIV-AFFECTED WOMEN AND CHILDREN

As rates of HIV infection and AIDS increase in women of child bearing age, HIV/AIDS has evolved into a disease of families with children. Th is is reflected in increasing numbers of HIV-infected children as well as rapidly growing numbers of children and adolescents losing parents to AIDS. Each stage of HIV disease, including diagnosis of HIV infect ion, illness progression, late-stage illness, death, and family reconf iguration presents particular mental health challenges to infected par ents and their affected children. Children who are themselves HIV-infe cted must also confront the psychological issues of adapting to a chro nic, terminal illness as well as the effects of HIV progression on dev elopment and cognition. In the United States, HIV illness commonly str ikes in families already struggling with substance abuse, psychiatric disorder, and multi-generational histories of victimization and trauma . Where present, these problems can complicate family adaptation to th e stressors of HIV disease. Clinicians working with HIV-affected famil ies need expertise in the mental health issues associated with substan ce abuse as well as those associated with the course of HIV illness.