Hugs and kisses: HIV-infected parents' fears about contagion and the effects on parent-child interaction in a nationally representative sample

OBJECTIVES: To determine the effect of human immunodeficiency virus (HIV)-related fears on HIV-infected parents' interactions with their children and to identify parents who might be at greater risk of avoiding interactions because of these fears. PARTICIPANTS: In-person interviews with 344 parents from a nationally representative probability sample of adults receiving health care for HIV in the contiguous United States. MAIN OUTCOME MEASURES: Parents' fear of transmitting HIV to their children, fear of catching an illness or opportunistic infection from their children, and avoidance of 4 types of interactions (kissing on the lips, kissing on the cheeks, hugging, and sharing utensils) because of these fears. RESULTS: Forty-two percent of parents feared catching an infection from their children, and 36.1% of parents feared transmitting HIV to their children. Twenty-eight percent of parents avoided at least 1 type of interaction with their children "a lot" because they feared transmitting HIV or catching an opportunistic infection. When parents who avoided physical interactions "a little" are included, the overall avoidance rate rises to 39.5%. Hispanic parents were more likely than African American parents and parents who were white or of other races or ethnicities to avoid interactions. CONCLUSIONS: Although many parents feared transmitting HIV to their children or catching an infection from their children, few were avoiding the most routine forms of physical affection. They were much more likely to avoid interactions suggestive of fear of contagion through saliva. Clinicians may be able to provide education to HIV-infected parents and reassurance about HIV transmission and the safety of various activities.