This prospective study will investigate the patterns, predictors and consequences of family support provision for persons with symptomatic HIV illness. Data from baseline and monthly followup interviews -- totalling 2502 interviews with 267 adult respondents -- will be used to model the dynamics of family support both cross-sectionally and over the course of illness, and their effect on depressed mood and other dimensions of adaptation to illness. Data will be drawn from an existing cohort of persons with HIV illness in New Jersey, who are being followed in a study of cost and utilization of formal health care services; this cohort includes good representation of minority group members, women, and injection drug users as well as gay men. Cross-sectional analyses of data from in-depth baseline interviews will be used to map the social networks of respondents and the roles of families of origin and families of commitment; measure the types, amounts, and sources of instrumental, personal care, and emotional support received by respondents; evaluate variations in patterns of family support by gender, ethnicity, risk group, and other patient characteristics; and analyze the relationship of support received and other covariates to measures of depression, anxiety, optimism, anger, suicidal ideation, and other mental health measures. Longitudinal analyses will use hazard methods for event histories and random-effects and fixed-effects linear models for repeated events. Predictors of instrumental, personal-care and emotional family support over the course of illness will be modeled, using followup data which provide an average of 10 interviews per respondent. These analyses will evaluate the dynamics of family support over the course of illness in relationship to health, functional status, and other time-varying predictors. Further models will evaluate the effects of family support on depressed mood and other adverse mental health outcomes over time, controlling for health, functional status, and other covariates. Results of these analyses will be used to provide an understanding of patterns of family support across major subgroups of persons with HIV disease; clarify the processes by which family support resources are mobilized or overwhelmed; provide insight into the determinants of potentially preventable adverse mental health outcomes and into possibilities for secondary prevention; identify strengths of family systems and barriers to more effective family support; and build a knowledge base to inform interventions that can assist families in more effectively supporting their members with HIV illness.
| Walkup, James; Satriano, James; Barry, Danielle et al. (2002) HIV testing policy and serious mental illness. Am J Public Health 92:1931-40 |
| Walkup, J; Sambamoorthi, U; Crystal, S (1999) Characteristics of persons with mental retardation and HIV/AIDS infection in a statewide Medicaid population. Am J Ment Retard 104:356-63 |
| Walkup, J; Crystal, S; Sambamoorthi, U (1999) Schizophrenia and major affective disorder among Medicaid recipients with HIV/AIDS in New Jersey. Am J Public Health 89:1101-3 |
