WHO ARE THE PRIMARY CARETAKERS OF CHILDREN BORN TO HIV-INFECTED MOTHERS - RESULTS FROM A MULTISTATE SURVEILLANCE PROJECT

Objective. To determine the primary caretakers of children born to wom en with human immunodeficiency virus (HIV) infection. Methods. We inte rviewed women at least 18 years of age who have been reported with HIV infection or acquired immunodeficiency syndrome to local health depar tments in 10 cities and states regarding the primary caretaker of thei r children born since 1977. Results. Of 541 HIV-infected women who had been pregnant since 1977, 88% had living children. These women compri sed 478 family units (mother and children); 234 (49%) of these units c onsisted of two or more children. The most common primary caretakers f or all children within a family unit were the mother alone (46%), gran dparents (16%), and both mother and father (15%). When the mother used injection drugs or lived alone, in a shelter, or with friends, almost one quarter of ail children were cared for by their grandparents. Onl y 30% of the mothers knew about child care assistance services, and on ly 8% had contacted or used these services. Conclusions. Mothers with HIV, often alone, are the primary caretakers of their children. Increa sed provisions for child care assistance and planning for future perma nent placement of orphaned children are urgently needed.