OBJECTIVE: Associations between human immunodeficiency virus (HIV) status of injection drug users (IDUs) and their children's psychopathology and social functioning were examined. METHOD: Parents (N = 61) were drawn from an ongoing longitudinal study of inner city, primarily African-American IDUs. Children (N = 79) were 6 to 11 years of age, currently living with the IDU parent. Parental variables included HIV status, apparent and inapparent HIV infection (with HIV-related medical symptoms and/or disclosure of parental HIV status to children; with neither medical symptoms nor disclosure, respectively), presence of HIV-related medical symptoms, HIV disclosure status to each child, and depression as ascertained by the Center for Epidemiologic Studies-Depression. Children's outcomes (competencies, psychiatric symptoms, and disorders) were assessed with the Child Behavior Checklist and the Schedule for Affective Disorders and Schizophrenia for School-Age Children. RESULTS: Children of IDU parents exhibited high rates of psychopathology. Parental HIV infection per se had no discernible impact on children's outcomes. The apparent HIV infection of a parent was associated with an eightfold increase (odds ratio 7.80; 95% confidence interval 1.56-39.09) in the prevalence of disruptive behavior disorders (compared with children of HIV-negative parents). Parental depression was associated with a threefold increase in the prevalence of children's disruptive behavior disorders (odds ratio 3.49, 95% confidence interval 1.11-11.04). CONCLUSIONS: Parental HIV status per se does not seem to have a differential impact on the affected children. The apparent HIV infection of a parent may be associated with children's externalizing symptoms and disorders.