Children with perinatally transmitted HIV infection are beginning to respond to treatment by living longer. HIV disease is considered a new form of chronic illness. Yet, HIV disease differs in many respects from other types of conventional chronic illnesses in children, and its effects on the family and caretakers may be expected to differ. The proposed study has three objectives: 1. To determine if there are differences in family characteristics between families having children with perinatally transmitted HIV infection/disease and families having children with comparable chronic illness; 2. To determine if there are interaction effects of family type (biological, extended and foster families) and type of chronic illness (HIV, cancer or Sickle Cell Disease) on family characteristics; and 3. To determine if a profile of family characteristics can be developed to discriminate between biological, extended, and foster families of children with HIV infection/disease, and families of children with comparable chronic illness. Specifically, the research will accomplish these objectives through a 3x3 comparative design study of caretakers of HIV affected children and caretakers of children with comparable chronic illnesses - cancer and Sickle Cell Disease. Quantitative data on four variables depicting level of family psychological function will be collected one time at the child's routine outpatient clinic visit. Variables will be compared in a 3x3 design which is constructed according to type of chronic illness (HIV, cancer, Sickle Cell Disease) and type of family unit (biological, extended, foster). All caretakers will be from the same geographic, socioeconomic, and demographic groups. Measures of family function include: degree of family adaptability and cohesion; family perceptions of stressful life events; family coping strategies; and relationships between family and external social units, functional task- oriented subsystems and intrafamilial relationships. Findings will provide baseline data on similarities and differences between families of children with HIV and other chronic illnesses. Such data will allow for further determination of effects of caretaker environment on child well-being and disease progress; and for testing models of chronic illness care delivery for these families.
