Few HIV-infected parents have guardianship plans

NEW YORK (Reuters Health) - The majority of HIV-infected unmarried parents have not legally designated a guardian to care for their children in the event of their death, research suggests.

"Guardianship planning is believed to help children cope with the loss of a parent, perhaps by reducing the likelihood that a child is shuffled from one home to another, spends prolonged periods in foster care, or is separated from siblings," the researchers say.

The new findings, which appear in the journal Pediatrics, are based on a study of 222 HIV-infected unmarried parents with 391 children who were interviewed regarding guardianship planning.

Dr. Burton O. Cowgill, from the University of California at Los Angeles, and colleagues focused on unmarried parents since guardianship planning would be unnecessary with married parents because the surviving parent is usually given automatic custody.

Just 28 percent of parents had a legal guardianship plan, but 53 percent of parents reported having a person identified who agreed to guardianship, the report indicates. Twelve percent of parents had yet to identify a guardian.

Grandparents were the most commonly cited preferred guardians, noted by 36 percent of respondents, followed by other relatives in 34 percent of cases and other biological parents in 17 percent.

Predictors of completed guardianship planning were a low CD4+ cell count, indicating more advanced HIV infection, and living without other adults, the report indicates.

Pediatricians and caregivers could play a key role in facilitating guardianship planning, the authors say.

SOURCE: Pediatrics, February 2007.