FCYU-Feature Story

Double Whammy
How AIDS affected the foster care system.

In the late 1980s, the growing HIV/AIDS epidemic, combined with the sudden appearance of crack cocaine, was tearing families apart. Many HIV positive babies and children were entering the system, especially in New York. At the time, health officials barely understood what HIV was or how it was spread, and many foster parents feared taking HIV positive children into their homes. Researcher Tim Ross, PhD, and Dr. Anne Lifflander of the Vera Institute for Justice explained HIV/AIDS's impact on the system:

Q: How did AIDS impact the foster care system in New York?

Ross: Big cities like New York were hit hardest by the AIDS epidemic. In the late '80s, the foster care system in New York City faced a double whammy-there was an epidemic of crack cocaine use that hit women particularly hard, and there was this new disease that no one knew anything about.

Lifflander: Pediatricians were all of a sudden confronted with babies that were increasingly sick. At the same time, the parents were beginning to not feel very well, and no one knew what was wrong. Many of these infected families were also struggling with other problems like poverty, alcoholism and substance abuse. Families where one or both parents and some of the children had HIV were just not able to take care of themselves.

Ross: The system had never faced anything like this before. From 1985-1990, the number of kids in care in New York tripled, from 17,000 to about 50,000. So many kids were being put in care that when it came to placing kids with HIV it was really hard to find placements-there just weren't enough foster parents out there. And a lot of potential foster parents were still scared of the disease-there was a lot of stigma that came along with being HIV positive.

So for a while you had what became known as the "boarder babies" problem-kids were literally growing up in hospitals, because they couldn't find homes. It got to the point that Princess Diana came to the city and visited the hospitals to try to recruit new foster parents.

Q: How did the city respond?

Ross: Medical centers and foster care systems started developing specialized units to deal with HIV and AIDS. In New York, the city's child welfare administration (now known as ACS) created a special Pediatric AIDS Unit to handle things like testing kids in care who might be infected and training foster parents who were taking care of children with HIV.

AIDS tended to hit entire families, and the systems the city had in place were not designed to deal with that. So other new programs that specifically targeted families started being developed. One example is Highbridge Woodycrest, in the Bronx, which is a housing program designed to give families affected by AIDS a place to live together and get the services they need. That program and others like it prevented infected families from being separated.

Q: It's been 25 years since the first AIDS cases were reported. How have things changed?

Lifflander: Today, the impact of HIV/AIDS on families has been greatly reduced. There are far fewer babies born with HIV because of medical advances; the infection rate among babies born to mothers with HIV has gone from about 25 percent to less than 6 percent. The number of adults getting HIV has also gone down. And thanks to better treatments, adults with HIV are living longer and more productive lives.

Ross: But one thing we're seeing more of is that HIV is now spreading a lot more in the rural South and other areas, which are not as well equipped to deal with managing the disease. There's also been a growing problem with parents using methamphetamine, a highly addictive drug. It's going to affect the foster care systems in those areas. We're hoping history doesn't repeat itself, but there are a lot of scary trends.