Increasing numbers of women are infected with HIV, particularly ethnic minority mothers. Mothers living with HIV (MLH) must sustain high quality parenting while coping with a chronic or terminal illness. At least 30 percent of MLH experience problem drinking, which will significantly impair their abilities to meet parenting challenges, including those associated with HIV infection, and to negotiate safer sex and manage drug use. Building on successful intervention research; namely, a study we conducted with parents with AIDS (Rotheram, Lee & Gwadz, in submission); cognitive-behavioral interventions for alcohol abuse (NIAAA, 1995), and a project for families with alcohol-abusing parents of children aged 6-12 years (Aktan. Kumpfer, & Turner, 1996), the goal of this proposal is to design, implement, and evaluate over 24 months the """"""""Family First"""""""" program, an intervention for MLH with problem-drinking who are raising adolescent children (aged 12-18 years). MLH (n=150) will be recruited from two clinical sites in New York City and randomly assigned to either: 1) the """"""""Family First,"""""""" intervention or 2) a Brief Video Intervention. Based on the Social Action Model (Ewart, 1991), the """"""""Family First"""""""" intervention will be conducted in individual sessions with the MLH over two modules (total 17 sessions) that target: a) reducing or eliminating problem drinking/drug use; b) improving the quality of parenting, and secondarily, c) reducing sexual risk behavior. To evaluate the effectiveness of the intervention, the MLH will be assessed at 3, 6, 12, 18, and 24 months following recruitment. The intervention is anticipated to improve parenting monitoring, skills, and bonds; therefore, the adolescent children of the MLH (n=210) will also be assessed at recruitment, 6, 18, and 24 months. The project will contribute to the field in five major areas: I) a gender-tailored and culturally-appropriate intervention will be developed for MLH with alcohol problems, a group at higher risk for the negative effects of alcohol than men, and typically with sole responsibility for their children; 2) individual intervention sessions will be conducted which include only MLH and not their children (many of whom cannot attend an intervention because they have not been informed about the MLHs diagnosis); 3) the intervention targets mothers of adolescents and provides MLH with an opportunity to delay/prevent problem drinking, drug use, and risk behavior among their teens; 4) the impact of the theoretical constructs in the Social Action Model will be evaluated; and 5) the cost-effectiveness of the intervention will be assessed.
| Leonard, Noelle R; Gwadz, Marya Viorst; Cleland, Charles M et al. (2008) Maternal substance use and HIV status: adolescent risk and resilience. J Adolesc 31:389-405 |
