Abstract
Parents living with HIV (PLWH) are often affected by co-occurring trauma, substance use, and mental health concerns. These complex challenges may contribute to intergenerational transmission of health risk, yet few studies have examined how these challenges affect family well-being in HIV-affected families. HIV care providers' insights can inform prevention efforts. Our study used qualitative focus group methods in two Southeast U.S. cities to explore providers' perceptions of PLWH's challenges navigating parenting and HIV-related concerns and strengths supporting positive adaptation. Six themes emerged: PLWH's challenges; strengths; COVID-19 impacts; impact of trauma, mental health, and substance use; supports needed; and engagement strategies. Providers highlighted trade-offs between parents' self-care and parenting and that parents often draw strength from their children. Challenges identified were both common to parenting and unique to living with HIV. Results underscore the need for multilevel prevention, including addressing basic needs; integration of mental health and medical services; and increased family services.