Objectives: To describe and to examine predictors of making custody plans by parents living with the human immunodeficiency virus (HIV) infection.
Interventions: The custody plans of 296 parents living with HIV for 708 children were examined over 5 years, with at least 85% reassessed annually.
Results: Over time, increasing numbers of parents living with HIV made custody plans for all of their children (23.8%-52.8%), typically with extended family members. However, parents change plans frequently, and 44.8% of parents living with HIV died without custody plans. Custody planning was less likely in families with only adolescent children, when parents had a partner, or when parents were depressed. Parents' disclosure of HIV status, physical health status, substance use, and ethnicity were unrelated to making custody plans.
Conclusion: Custody planning is a slow and unstable process in families affected by HIV.