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Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review

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Abstract

A variety of interventions have been tested targeting people living with HIV (PLH) and their relationships with their children. The purpose of this study was to synthesize evidence on the goals, types, scope, and outcomes of such intergenerational interventions for PLH. Randomized trials targeting PLH alone or together with their children, published in English, with an intergenerational intervention component were included in this review. Thirteen studies met eligibility criteria. The types and goals of interventions varied greatly but often involved educational sessions with groups of PLH, skill-building sessions, or parental disclosure of HIV status among mothers living with HIV; six studies targeted problem behaviors, resilience, and self-esteem among their children. Two studies addressed general family coping with HIV. Seven studies reported positive outcomes as a result of an intergenerational intervention, with the greatest improvements being observed in those participants with the most stress. Most studies failed to report specific intervention methodology. Due to gaps in the literature noted, future intergenerational interventions targeting PLH should include more diverse groups of PLH. Studies should also explore the impact of intergenerational-based interventions on the mental health of PLH and their families.

Resumen

Una gran variedad de intervenciones se han puesto en práctica para analizar y evaluar a las personas que actualmente están viviendo con el VIH y las relaciones con sus hijos. El propósito de este estudio ha sido para sintetizar evidencia de las metas, tipos, alcances y resultados de las intervenciones intergeneracionales que se han hecho de las personas que están viviendo con el virus. Trece de los estudios alcanzaron los requisitos necesarios para ser incluidos en esta revisión literaria. Las metas que se querían alcanzar en las distintas intervenciones variaron gradualmente pero casi siempre contaron con secciones educativas entre los grupos de personas afectadas, secciones para el desarrollo de habilidades y revelaciones de los padres acerca del estado de cero positivo entre las madres viviendo con el VIH. A raíz de una intervención intergeneracional, siete de los estudios realizados reportaron resultados positivos donde se observó un gran avance entre los participantes con un mayor grado de estrés. Varios de los estudios no reportaron una intervención metodológica. Basado en algunas brechas notadas en la literatura científica estudiada, las futuras intervenciones intergeneracionales deberían incluir más diversidad entre los grupos estudiados. Los estudios deberían también explorar el impacto de las intervenciones intergeneracionales en la salud mental de las personas afectadas y sus familias.

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Acknowledgements

This study was supported by a grant from the Hopkins Center for AIDS Research (P30 AI094189) and in part by a grant from the Dorothy Evans Lyne Fund. Additional resources were provided by Center for Cardiovascular and Chronic Care at the Johns Hopkins University School of Nursing. Dr. Kim was a post-doctoral fellow at The Johns Hopkins University when this work was initiated. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Conceived and designed the study: HRH. Conducted the literature search and screening/inclusion process: OF, KK, JC, SS. Conducted the data extraction: OF, KK, JC. Analyzed the data: HRH, OF, KK, JC. Contributed analysis: NW, PS. Wrote the paper: HRH, OF, KK. Contributed to the revision process: HRH, OF, KK, JC, SS, NW, PS.

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Correspondence to Hae-Ra Han.

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Han, HR., Floyd, O., Kim, K. et al. Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review. AIDS Behav 23, 21–36 (2019). https://doi.org/10.1007/s10461-018-2223-1

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