Lapriah Morrison soc 482 Dr. Donna Cole December 4, 2013 HIV-lnfected Parents and Their Children in the United States HIV has an insightful influence not only on the people it infects, but also on their families. Children who are dependent on their parents are particularly vulnerable. Because of the effects of HIV disease and the social conditions that are often associated with it, parents living with HIV may have limited financial, social, and emotional resources to draw upon in raising their children.
Additionally, if parents become incapacitated or die, others need to take over the role of caring for the children. Children and families of people with HIV may depend on public and charitable resources that cover such services as income supplementation, health care, child care, housing, bereavement support, foster care, and adoption. These services are not always available, and the dishonor associated with HIV can complicate access to such services.
To address the needs of children and families affected by HIV, they needed to know the extent and importance of the problem. Analysis Nationally representative data have not previously been available to describe this population, although the percentage of HIV infected adults with hildren has been reported for regional and convenience samples. 10-12 studies have estimated the number of children with vertically acquired infection and the percentage of childbearing women who are HIV infected. 4-16 several researchers have used modeling techniques to estimate the number of children in the United States who have lost or will lose their mothers because of HIV. These studies have drawn attention to the fact that HIV affects more than Just those who are infected. To gain a better understanding of parenthood and family responsibilities among HIV nfected adults in the United States, they used data from a national probability sample of men and women who are receiving health care for HIV to determine who had children the ages of the children, and with who the children lived with.
Methods The HIV Cost and Services Utilization Study used multistage national probability sampling to select a random sample of adults with known HIV infection who had at least one visit for health care at a facility other than a military, prison, or emergency department facility during a two month population definition period in 1996. They also sampled geographical areas, medical providers, and then patients. In the first stage of sampling, they sampled metropolitan statistical areas with the largest AIDS caseloads, along with an additional 20 metropolitan statistical areas and 24 clusters of rural counties.
In the second stage of sampling, they sampled 58 urban and 28 rural “known providers” from list of all providers known by local informants to sampled 87 urban and 23 rural “other providers” who had affirmed caring for HIV patients in a screening survey of approximately 4000 physicians randomly selected rom the physician master file maintained by the American Medical Association. In the third stage of sampling, they sampled patients from anonymous lists of all eligible patients who had visited participating providers during the population definition period.
Women and members of staff model health maintenance organizations were oversampled. Data collection began in January 1996 and ended 15 months later. Their overall rates were 68% for full interviews and 87% for people with abbreviated interviews or information supplied by others. In total they gained 2864 full interviews. Living Arrangements for Children Fifty-two percent of children 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 their grandmother (9% of all children), with another relative (5%), with an unrelated foster or adoptive parent (4%), or in another situation. Living situation varied a lot by the sex of the respondent. Sixty-nine percent of children of a female respondent lived with the respondent and 6% lived elsewhere with their father, whereas 32% of children of a male respondent lived with the respondent and 53% ived elsewhere with their mother. There was no significant decrease in the proportion of children who lived with their parent.
Infected Adults Living With Their Children HIV- Women were much more likely than men to be living with their children: 76% of women with children (and 45% of all women) and 34% of men with children (and 6% of all men) lived with at least 1 child. Among women and men living with children, 15% and 21%, respectively, had at least 1 child living elsewhere. The possibility that a respondent lived with his or her children varied by household income for women and en and by the respondent’s level of education.
Percentages of Children Younger Than 18 Years in Various Living Arrangements, by Sex of Respondent: HIV Cost and Services utilization study, 1996-1997 Living Arrangement Female Male Respondent parent 69 32 Other parent 6 53 Grandmother 10 8 Another relative 3 Unrelated adoptive/foster parent 2 Other Health of and Available Support for Parents Living With Children Many parents were at a fairly advanced stage of illness that could have been affecting their ability to take care of their child.
Twenty-three percent of parents living with children eported that their lowest CD4 count was 50 to 199, and 22% reported less than 50. Sixty percent of parents living with their children had symptomatic HIV, and another 30% had AIDS. Many of the parents may have been too sick to tend to their children’s needs or may have had other conditions that interfered with their ability to take care of their children. For example, 21% of parents living with children had been hospitalized during the previous 6 months, including 10% who had been hospitalized for 7 or more days. 0% of parents who had been hospitalized during the previous 6 onths were also living with a spouse or partner. Eighteen percent of parents living with children had needed home health care in the previous 6 months; 45% had symptoms consistent with a psychiatric disorder; 10% showed evidence of probable past drug dependence; 5% had been heavy alcohol drinkers in the previous 4 weeks; and 10% had needed drug or alcohol treatment in the previous 6 months.
Although many parents appeared to have resources available to draw upon, some parents lacked social networks that could pick up the slack if they were unable to take care of heir children’s needs, and some had limited financial resources. Twenty percent had no close friends, and 16% saw family members once a month or less. Twenty-five percent had no one to lend them money, and 16% had no one to help with chores.
Thirteen percent had gone without needed health care at least once in the previous 6 months, because they needed the money for basic necessities such as food, clothing, and housing, and 8% had gone without basic necessities because they needed the money for health care. Some put off going to the doctor because they were too sick 19%), they were taking care of someone else (16%), or they did not have a way to get there (23%). Twenty percent had had to find a place to live in the previous 6 months.
Sixty-seven percent were participating in 1 or more government supplemental income programs and 31% received Supplemental Security Income, 31% received Social Security Disability Insurance, and 39% received Aid to Families with Dependent had private insurance, and 17% had no health insurance. Conclusion In this sample of HIV-infected adults in care, we have shown that many throughout the country have children and some continue to conceive and have hildren after diagnosis. HIV-infected parents generally continue to live with their children even as their disease progresses.
If there are any future plans of the epidemic they 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. Parents may need support in meeting conflicting responsibilities of looking after their own health needs while also taking care of their children. 51 the children, as well having needs related to their parent’s HIV infection, ncluding financial assistance, emotional support, and supervision when the parent is incapacitated or dies.
HIV-infected adults could also benefit from counseling and support when making decisions about having children. Unfortunately, even if transmission rates decrease many parents are already infected, and the disease will continue to have a large impact on families and on how society treats them. Reference Page 1 . Caldwell MB, Mascola L, Smith W, et al. Biologic, foster, and adoptive parents: care givers of children exposed perinatally to human immunodeficiency virus in the United States. Pediatrics. 199Z90:603-607. 2. Carten A], Fennoy I.
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