Healthy children in families affected by AIDS: Epidemiological and psychosocial considerations

Traditional means of conceptualizing the psychosocial impact of AIDS have emphasized infected individuals out of their natural context AIDS occurs not simply within hospitals but within families. A secondary morbidity occurs within a family system when one of its members is infected. Clinical experience suggests that non-infected children within families with AIDS are at significant risk for poor developmental outcomes as a consequence of the skewing of familial resources. Children living in families who have a member infected by HIV are impacted by isues such as stigma, isolation, abandonment, and death. This article explores the epidemiology of this child population and risk factors that render them vulnerable. Social workers are in a unique position to identify and serve these children in such diverse settings as schools, welfare agencies, and hospitals. Suggested interventions based on the developmental stage of the child are discussed as are implications for policy formation and program development.