Continuity of mental health services across the continuum of parental HIV illness, death, and family reconfiguration is essential to meeting the mental health needs of HIV-affected children and adolescents. Many parents strongly desire secrecy and confidentiality because they want to protect their children from ridicule and because they are afraid that child welfare programs may take their children away from them. Frequent staff outreach and flexible scheduling often is needed to keep HIV-affected families engaged in services. It is often helpful to provide services in the home in order to gain the family's trust. Home-based services are especially important for parents with end stage HIV disease.
Women caring for children face unique logistical barriers to accessing services.
These include the need for child care to attend appointments, the cost of transporting the entire family, and managing appointments for multiple family members. Frequently coordinated case-conferencing is necessary to address both the needs of individual family members and the family as a unit. We now know how complex their needs are and the kinds of services that will be successful.