Forty-eight parents of children with HIV infection (n = 31) and uninfected perinatal HIV exposure (n = 17) completed standardized measures and semistructured interviews to assess the coping behaviors they use to mediate the impact of HIV infection on the family system. Coping behaviors that focus on strengthening family life and relationships and developing and maintaining a positive outlook on life were most often reported as helpful by parents in both groups. No differences were found between the groups on measures of parental coping. The family integration, cooperation and optimistic view of situation coping pattern was significantly related to personal impact, familial and social impact, coping impact, and caregiver burdens impact. Coping behaviors directed at understanding the medical situation were significantly related to caregiver burdens impact. Implications for future research and practice are discussed.