The HIV/AIDS epidemic in the United States humbles those who try to ameliorate its impact on children and families. Certainly, more resources are available than in Africa or Asia and the scale of the epidemic is much less daunting, but the problems of affected families and communities are so entrenched and unyielding that efforts to address the problems directly related to the disease reach only the most visible aspect of troubled families' lives. Despite the differences in culture, resources, and experience with disease between the United States and other areas affected by the global epidemic, at the most basic human level there are also strong similarities. Parents grieve the deaths of children; grandmothers take on the care of their grandchildren; children's lives are irrevocably altered by a parent's death. There is much in common and much to learn from each other, even as we pursue different strategies to treat the wounds.

In this chapter we present a brief review of the HIV/AIDS epidemic in the United States and New York City and the response of The Family Center to the epidemic. We focus on some of the issues relating to children and families that have been the hardest to address and resolve, and conclude by suggesting some practices that reflect what The Family Center has learned over the past ten years.