ABSTRACT
Portrayals of children being affected by a parent's illness or death from HIV/AIDS typically involve survivors from high-prevalence countries in sub-Saharan Africa. Little is known about such children in the United States, even though HIV/AIDS is a significant cause of morbidity and mortality for adults of childbearing age. To address this issue, the present study investigated children who had been orphaned (or were at risk of being orphaned) in the American Deep South. The study also sought to describe the family contexts of at-risk children. Three research methods were used: a chart review of deceased and active adults at a public HIV clinic; an obituary review; and an examination of data from a statewide needs-assessment survey. The triangulated results indicated that at-risk children outnumbered orphans by 2 to 1. Most of these at-risk and orphaned children were African Americans living in abject poverty and facing an uncertain future. Privacy issues raised problems in identifying the children, and knowledge of their whereabouts was hampered by HIV-related stigma. Further research is needed to assess the needs of children for health policy purposes and to identify this group as a special population for intervention or referral to social services.
The author would like to thank Elmyra Jones and Debra Florea of the Alabama Council for Developmental Disabilities (ACDD); James Waid and Laurie Dill and staff of the Montgomery AIDS Outreach (MAO); Robert Jenkot for his role as project director; Anil Mujumdar, Stanley L. Brodsky, and Kathy Hiers for their technical contributions; Ashley Cornelius, Alana Grey, Maya Henson, and Laura Wester for data collection; Kathy Hiers at AIDS Alabama for the survey data, and the AIDS Outreach staff in Alabama for their support and participation.
The research for this article was supported, in part, by the Innovative Ideas Grant G5 4311-51 from the ACDD and the Alabama Department of Mental Health and Retardation (ADMHR).
Notes
aAges of deceased and active clients were calculated from date of birth to last chart entry.
bIncome from all sources ranged from $150 to $4,200 a month. Average income was $960.00 a month for clients in paid employment.
cUsually a mother, grandmother, or other female relative.
aDeath notices consist of announcements and obituaries. These notices display the deceased's name and funeral arrangements. Survivors are not listed. By contrast, the obituaries give detailed information. Step-children were counted in the totals.
bNotices in the charts and newspaper were matched by name, address, and date of death to eliminate duplication.
cNewspaper obituaries were usually preceded by brief funeral announcements. To avoid counting the deceased person twice, an announcement was discounted when followed by an obituary.
dIn addition to 137 children, 144 grandchildren were listed in the newspaper obituaries.
a Source: AIDS Alabama (2003).
b A total of 286 active charts (out of 801) lacked information on whether the client had children. Thus, the calculations were made on the basis of 515 charts for known parents. Most of these parents had more than one child (83%). Fifty-five percent of clients had three or more children. Twenty-eight percent had four or more children.
c This figure is based on survey responses to the question: “How many children have you raised?” Clinic data were not included because exclusion of nondependent children from the charts (e.g., for men whose children lived with their mother) yielded an undercount.