The number of parents living with HIV is significant and rising, as the length and quality of life of persons living with HIV has increased. When mothers become infected with HIV, they face not only the challenges associated with their infection, but their entire family is affected, with long-term negative outcomes for themselves and their children. This research team completed previous randomized controlled trials with parents with HIV and their children and young people living with HIV, suggesting the benefits of improving coping skills, family relationships, and dealing with illness-related tasks (e.g., disclosure). The proposed trial builds on these results to implement prevention services in treatment settings to improve long-term outcomes for mothers and their adolescent children, gathering evidence to inform dissemination. All MLH with adolescent children at three sites in the Los Angeles Pediatric AIDS Consortium (n=400 MLH) will be randomly assigned within site to one of two conditions: 1) a four module intervention (16 sessions) and access to booster sessions, as needed (n=200 MLH; 320 youth); or 2) a standard care condition (n=200 MLH; 320 youth). The MLH's intervention will address improved health behaviors (Module 1), parenting skills and family relationships (Module 2), reduced transmission acts and problem behaviors (Module 3), and improved mental health (Module 4). For youth who know the MLH's serostatus, the intervention will be delivered in conjunction with three of the MLH's modules and address coping with parental illness (MLH's Module 2), reducing multiple problems behaviors (Module 3), and improving mental health (Module 4). Youth whose MLH die will receive a fourth module to cope with parental bereavement and to set new life goals. The impact will be assessed over two years (recruitment, 3, 6, 12, 18, & 24 months), in a design that is a blend of an efficacy and effectiveness trial. The outcomes will be MLH's health status, and youth and MLH's parent-child relationships, problem behaviors, and mental health symptoms. In addition, youth's developmental outcomes will be monitored. In order to assess the uniqueness of the impact of HIV, we will assess a cohort of parents and adolescents in a neighborhood control group (n=200 mothers; 320 youth) matched for age, gender, and ethnicity on the same measures.
