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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH068194-04
Application #
7096535
Study Section
AIDS and Related Research 8 (AARR)
Program Officer
Brouwers, Pim
Project Start
2003-09-12
Project End
2008-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
4
Fiscal Year
2006
Total Cost
$1,449,613
Indirect Cost
Name
University of California Los Angeles
Department
Psychiatry
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Rotheram-Borus, Mary Jane; Stein, Judith A; Rice, Eric (2014) Intervening on conflict, parental bonds, and sexual risk acts among adolescent children of mothers living with HIV. PLoS One 9:e101874
Rotheram-Borus, Mary Jane; Rice, Eric; Comulada, W Scott et al. (2012) Intervention outcomes among HIV-affected families over 18 months. AIDS Behav 16:1265-75
Dyer, Typhanye Penniman; Stein, Judith A; Rice, Eric et al. (2012) Predicting depression in mothers with and without HIV: the role of social support and family dynamics. AIDS Behav 16:2198-208
Lester, Patricia; Stein, Judith A; Bursch, Brenda et al. (2010) Family-based processes associated with adolescent distress, substance use and risky sexual behavior in families affected by maternal HIV. J Clin Child Adolesc Psychol 39:328-40
Sánchez, Mónica; Rice, Eric; Stein, Judith et al. (2010) Acculturation, coping styles, and health risk behaviors among HIV positive Latinas. AIDS Behav 14:401-9
Glover, Dorie A; Garcia-Aracena, Elena F; Lester, Patricia et al. (2010) Stress biomarkers as outcomes for HIV+ prevention: participation, feasibility and findings among HIV+ Latina and African American mothers. AIDS Behav 14:339-50
Bursch, B; Lester, P; Jiang, L et al. (2008) Psychosocial predictors of somatic symptoms in adolescents of parents with HIV: a six-year longitudinal study. AIDS Care 20:667-76