Cowgill Burton O, Beckett Megan K, Corona Rosalie, Elliott Marc N, Zhou Annie J, Schuster Mark A
Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine, University of California, 1072 Gayley Ave, Los Angeles, CA 90024, USA.
Pediatrics. 2007 Sep;120(3):e494-503. doi: 10.1542/peds.2006-3319.
The purpose of this work was to determine the rates and predictors of custody status for children of HIV-infected parents.
Data came from interviews of 538 parents with 1017 children (0-17 years old) from a nationally representative sample of HIV-infected adults receiving health care in the United States. Outcomes were collected at 2 survey waves and included child custody status and who, other than the HIV-infected parent, had custody of the child. Child custody status was categorized as (1) in custody of HIV-infected parent at both survey waves, (2) infected parent had custody at first survey wave but not second survey wave, (3) not in custody of infected parent at either survey wave, and (4) infected parent gained custody between survey waves. Potential custodians included (1) other biological parent, (2) state, foster, or adoptive parent, (3) grandparent, and (4) relative, friend, nonbiological parent, or other. Multinomial logistic regression modeled both outcomes.
Forty-seven percent of the children were in the custody of their HIV-infected parent at both survey waves, 4% were in the parent's custody at the first but not second survey wave, 42% were not in custody at either survey wave, and the parent of 7% gained custody between survey waves. Parents cited drug use (62%) and financial hardship (27%) as reasons for losing custody. Children of HIV-infected fathers, older parents, parents living without other adults, parents with low CD4 counts, drug-using parents, and parents with > or = 1 hospital stay were less likely to be in their parent's custody at either survey wave.
More than half of the children were not in custody of their HIV-infected parent at some time during the study period. Pediatricians and others taking care of children with HIV-infected parents may be able to offer counseling or referrals to assist parents with child custody issues.
本研究旨在确定感染艾滋病毒父母的子女监护状态的发生率及预测因素。
数据来自对538名父母及其1017名子女（0至17岁）的访谈，这些父母来自美国接受医疗保健的具有全国代表性的感染艾滋病毒成年人样本。在两轮调查中收集结果，包括儿童监护状态以及除感染艾滋病毒的父母外谁拥有孩子的监护权。儿童监护状态分为四类：（1）在两轮调查中均由感染艾滋病毒的父母监护；（2）感染艾滋病毒的父母在第一轮调查中有监护权但在第二轮调查中没有；（3）在两轮调查中均不由感染艾滋病毒的父母监护；（4）感染艾滋病毒的父母在两轮调查之间获得监护权。潜在监护人包括：（1）其他亲生父母；（2）州政府、寄养或领养父母；（3）祖父母；（4）亲属、朋友、非亲生父母或其他人。采用多项逻辑回归对这两个结果进行建模。
在两轮调查中，47%的儿童由感染艾滋病毒的父母监护，4%的儿童在第一轮调查中由父母监护但在第二轮调查中不是，42%的儿童在两轮调查中均不由父母监护，7%的儿童的父母在两轮调查之间获得监护权。父母将吸毒（62%）和经济困难（27%）作为失去监护权的原因。感染艾滋病毒的父亲的子女、年龄较大的父母、没有其他成年人同住的父母、CD4细胞计数低的父母、吸毒的父母以及住院次数≥1次的父母，在两轮调查中的任何一轮中由其父母监护的可能性较小。
在研究期间的某个时候，超过一半的儿童并非由感染艾滋病毒的父母监护。照顾感染艾滋病毒父母的子女的儿科医生和其他人或许能够提供咨询或转介服务，以协助父母解决子女监护问题。
