AIDS and Behavior

, Volume 16, Issue 5, pp 1265–1275

Intervention Outcomes Among HIV-Affected Families Over 18 Months

  • Mary Jane Rotheram-Borus
  • Eric Rice
  • W. Scott Comulada
  • Karin Best
  • Carla Elia
  • Katherine Peters
  • Li Li
  • Sara Green
  • Ena Valladares
Original Paper

Abstract

We evaluate the efficacy of a family-based intervention over time among HIV-affected families. Mothers living with HIV (MLH; n = 339) in Los Angeles and their school-aged children were randomized to either an intervention or control condition and followed for 18 months. MLH and their children in the intervention received 16 cognitive-behavioral, small-group sessions designed to help them maintain physical and mental health, parent while ill, address HIV-related stressors, and reduce HIV-transmission behaviors. At recruitment, MLH reported few problem behaviors related to physical health, mental health, or sexual or drug transmission acts. Compared to MLH in the control condition, intervention MLH were significantly more likely to monitor their own CD4 cell counts and their children were more likely to decrease alcohol and drug use. Most MLH and their children had relatively healthy family relationships. Family-based HIV interventions should be limited to MLH who are experiencing substantial problems.

Keywords

HIV+ mothers Family interventions Parenting behaviors Sexual behavior Substance abuse 

References

  1. 1.
    Murphy DA, Marelich WD, Hoffman D. A longitudinal study of the impact on young children of maternal HIV serostatus disclosure. J Clin Child Adolesc Psychol. 2002;7:55–70.Google Scholar
  2. 2.
    Rotheram-Borus MJ, Lee MB, Gwadz M, et al. An intervention for parents with AIDS and their adolescent children. Am J Public Health. 2001;91:1294–302.PubMedCrossRefGoogle Scholar
  3. 3.
    Rotheram-Borus MJ, Lee M, Leonard N, et al. Four-year behavioral outcomes of an intervention for parents living with HIV and their adolescent children. AIDS. 2003;17:1217–25.PubMedCrossRefGoogle Scholar
  4. 4.
    Rotheram-Borus MJ, Lee MB, Lin YY, et al. Six year intervention outcomes for adolescent children of parents with HIV. Arch Pediatr Adolesc Med. 2004;158:742–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Rotheram-Borus MJ, Stein JA, Lester P. Adolescent adjustment over six years in HIV-affected families. J Adolesc Health. 2006;39:174–82.PubMedCrossRefGoogle Scholar
  6. 6.
    Flay BR, Biglan A, Boruch RF, et al. Standards of evidence: criteria for efficacy, effectiveness and dissemination. Prev Sci. 2005;6:151–75.PubMedCrossRefGoogle Scholar
  7. 7.
    Vittinghoff E, Douglas J, Judson F, et al. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. Am J Epidemiol. 1999;150:306–11.PubMedCrossRefGoogle Scholar
  8. 8.
    Hall HI, Song R, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300:520–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Marel R, Galea J, Smith RB, et al. Drug use trends in New York city. In: Epidemiologic trends in drug abuse. Vol. 2. Proceedings of the Community Epidemiology Work Group. Bethesda: Department of Health and Human Services; 2006. p. 159–171.Google Scholar
  10. 10.
    Rutkowski B. Patterns and trends in drug abuse in Los Angeles, California: a semiannual update. In: Epidemiologic trends in drug abuse. Vol. 2. Proceedings of the Community Epidemiology Work Group. Bethesda: Department of Health and Human Services; 2006. p. 97–118.Google Scholar
  11. 11.
    Rice E, Lester P, Flook L, et al. Lessons learned from “integrating” intensive family-based interventions into medical care settings for mothers living with HIV/AIDS and their adolescent children. AIDS Behav. 2009;13:1005–11.PubMedCrossRefGoogle Scholar
  12. 12.
    Rotheram-Borus MJ, Murphy DA, Miller S, et al. An intervention for adolescents whose parents are living with AIDS. Clin Child Psychol Psychiatry. 1997;2:201–19.CrossRefGoogle Scholar
  13. 13.
    Lester P, Rotheram-Borus MJ, Elia C, et al. TALK: teens and adults learning to communicate. In: Lecroy CW, editor. Handbook of evidence-based treatment manuals for children and adolescents. New York: Oxford University Press; 2008.Google Scholar
  14. 14.
    Straus MA. Measuring intrafamily conflict and violence: the Conflict Tactics (CT) scales. J Marriage Fam. 1979;41:75–88.CrossRefGoogle Scholar
  15. 15.
    McGuire J, Earls F. Exploring the reliability of measures of family relations, parental attitudes, and parent-child relations in a disadvantaged minority population. J Marriage Fam. 1993;55(4):1042–6.CrossRefGoogle Scholar
  16. 16.
    Steele B. Violence in our society. Pharos. 1970;33:42–8.Google Scholar
  17. 17.
    Steele BF, Pollock CD. A psychiatric study of parents who abuse infants and small children. In: Hempe CH, Helfer RE, editors. The battered child. Chicago: University of Chicago Press; 1968.Google Scholar
  18. 18.
    Lutenbcher M. Psychometric assessment of the adult–adolescent parenting inventory in a sample of low-income single mothers. J Nurs Meas. 2001;9(3):291–308.Google Scholar
  19. 19.
    Bloom BL. A factor analysis of self-report measures of family functioning. Fam Process. 1985;24:225–39.PubMedCrossRefGoogle Scholar
  20. 20.
    Derogatis LR. Brief symptom inventory: administration, scoring, and procedures manual. Minneapolis: National Computer Systems, Inc; 1993.Google Scholar
  21. 21.
    Edwards RR, Moric M, Husfeldt B, Buvanendran A, Ivankovich O. Ethnic similarities and differences in the chronic pain experience: a comparison of African American, Hispanic, and White Patients. Pain Med. 2005;6(1):88–98.PubMedCrossRefGoogle Scholar
  22. 22.
    Wong FL, Lightfoot M, Pequegnat W, et al. Effects of behavioral intervention on substance use among people living with HIV: the healthy living project randomized controlled study. Addiction. 2008;103:1206–14.PubMedCrossRefGoogle Scholar
  23. 23.
    Namir S, Wolcott DL, Fawzy FI, et al. Coping with AIDS: psychological and health implications. J Appl Soc Psychol. 1987;17:309–28.CrossRefGoogle Scholar
  24. 24.
    Murphy DA, Rotheram-Borus MJ, Marelich W. Factor structure of a coping scale across two samples: do HIV-positive youth and adult use the same coping strategies? J Appl Soc Psychol. 2003;33:627–47.CrossRefGoogle Scholar
  25. 25.
    Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms and profiles. Burlington: University of Vermont; 2001.Google Scholar
  26. 26.
    Zimmerman RS, Khoury EL, Vega WA, Gil AG, Warheit GJ. Teacher and parent perceptions of behavior problems among a sample of African American, Hispanic, and Non-Hispanic White students. Am J Community Psychol. 1995;23(2):181–97.PubMedCrossRefGoogle Scholar
  27. 27.
    Hedeker H, Gibbons R, Waternaux C. Sample size estimation for longitudinal designs with attrition: comparing time-related contrasts between two groups. J Educ Behav Stat. 1999;24:70–93.Google Scholar
  28. 28.
    Hall D. Zero-inflated poisson and binomial regression with random effects: a case study. Biometrics. 2000;56:1030–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Sánchez M, Rice E, Stein J, Milburn NG, Rotheram-Borus MJ. Acculturation, coping styles, and health risk behaviors among HIV positive Latinas. AIDS Behav. 2010;14(2):401–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Richter L, Sherr L. Editorial: strengthening families: a key recommendation of the joint learning initiative on children and AIDS. AIDS Care. 2009;21:1–2.CrossRefGoogle Scholar
  31. 31.
    Li L, Lee S-J, Thammawijaya P, et al. Stigma, social support, and depression among people living with HIV in Thailand. AIDS Care. 2009;21:1007–13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Mary Jane Rotheram-Borus
    • 1
  • Eric Rice
    • 2
  • W. Scott Comulada
    • 1
  • Karin Best
    • 1
  • Carla Elia
    • 1
  • Katherine Peters
    • 3
  • Li Li
    • 1
  • Sara Green
    • 1
  • Ena Valladares
    • 1
  1. 1.Semel Institute for Neuroscience and Human Behavior, Center for Community HealthUniversity of California Los AngelesLos AngelesUSA
  2. 2.School of Social WorkUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.San Francisco Coordinating CenterUniversity of California San FranciscoSan FranciscoUSA

Personalised recommendations