Custody planning among parents living with HIV or AIDS (PLHAs) can buffer the negative impact of parental death. The formal and informal custody plans for 594 children by 253 PLHAs and the relationships among custody plans, parental health, and psychosocial status were examined. About one-half of the parents had no formal custody plan. Parents were more likely to make plans for younger children. In addition, formal custody planning was more likely to occur among parents who reported using positive action, withdrawal-depressive, passive problem solving, social support, or spiritual coping styles and who reported higher parental self-esteem. Parent's substance use and emotional distress were not significantly related to custody plans. These data suggest the need for interventions to encourage formal custody planning.