More Families Are Adopting HIV-Positive Children

The number of U.S. parents who have adopted or are considering adopting a child with HIV has surged in recent years.

Throughout most of the epidemic, strict U.S. immigration policies limited entry for people living with HIV. But that restriction was lifted in January 2010, enabling HIV-positive children to enter as easily as other adoptive children.

Most adoptions involve orphans from the developing countries that are home to some 2.5 million children living with HIV. In many of these nations, HIV-positive children face stigma, neglect, and early death.

Chicagoan Margaret Fleming, 74, has nine adopted children, including three HIV-positive first-graders. "These kids were, in many ways, the modern-day lepers," she said of the situations they came from. Fleming runs Chances by Choice, a support service that recruits and advises parents interested in HIV adoptions.

A key challenge for many families is deciding when and to whom they should disclose the adoptive child's HIV status. In February, the largest U.S. adoption agency, Bethany Christian Services, issued an educational package about HIV adoptions to help the growing number of interested parents make informed decisions. "Once your child's status is disclosed, you cannot 'take it back,' so careful consideration and thought should be given to this important issue," advises the agency.

Dr. Jane Aronson, a New York City pediatrician who specializes in caring for children adopted abroad, believes HIV-positive children have a right to keep their status private until they are ready and old enough to understand the consequences. "Some parents have made a decision to define their children's identity, now it's more about them than about the kids," she noted. "That could be very challenging when the children grow up. They didn't have a choice."

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