The purpose of this small 3-year R01 is to test the preliminary efficacy of an intervention to assist HIV- infected mothers to disclose their serostatus to their young (age 6-12 year old), well children. The basis for development of this intervention is work from two R01s (MH # 5R01MH057207, currently Yr. 09) designed to longitudinally assess HIV-positive mothers and their children, which included studies on maternal disclosure (e.g., Murphy, Marelich, & Hoffman, 2002; Murphy, Marelich, Hoffman, & Schuster, 2006; Murphy, Roberts, & Hoffman, 2002; Murphy, Roberts, & Hoffman, 2003; Murphy, Roberts, & Hoffman, 2006; Murphy, Steers, & Dello Stritto, 2001). This research suggests disclosure is difficult for mothers living with HIV (MLWHs), and that outcomes for both mothers and children could be improved by the proposed intervention. Information gathered in the previous two R01s will be used to develop a brief disclosure intervention. MLWHs (N = 80) will be randomly assigned to the intervention or control condition. MLWHs and children (N = 160) will be assessed at baseline, 3, 6, and 9-month follow-ups. A random subset of intervention mothers (n = 12) will be asked to participate in an in-depth qualitative interview after their last follow-up, to obtain detailed process information on their experiences in the study.
The aims of the intervention are to: improve mother-child communication and parenting skills-particularly as they relate to disclosure. As a result of the intervention aims, other primary and secondary outcomes include: increasing readiness to disclose, and disclosure itself; improving both MLWH and child mental health indicators; reducing child behavioral problems, and improving the parent-child relationship and family functioning. This study will provide important prospective, longitudinal data on MLWHs' adjustment to having disclosed their serostatus, and their children's adjustment to the disclosure. Previous research indicates that for some families, maternal and child psychological distress may increase immediately following disclosure, but will decrease over time; the longitudinal design of this study will allow us to follow mothers and children throughout the disclosure process. The study will allow evaluation of maternal and child characteristics that may moderate or mediate the impact of disclosure. Finally, process evaluations for each intervention session as well as in-depth qualitative interviews with a subset of MLWHs who attended the intervention will provide information on issues that need to be addressed prior to a full-scale trial of the disclosure intervention. Few interventions, other than for prevention or medication adherence, are available for women living with HIV; this study will evaluate an intervention that will help HIV-positive mothers deal with a serious family issue. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH077493-02
Application #
7335639
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Kamath, Susannah M Allison
Project Start
2007-01-01
Project End
2009-12-31
Budget Start
2008-01-01
Budget End
2008-12-31
Support Year
2
Fiscal Year
2008
Total Cost
$280,608
Indirect Cost
Name
University of California Los Angeles
Department
Type
Other Domestic Higher Education
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Murphy, Debra A; Armistead, Lisa; Marelich, William D et al. (2011) Pilot trial of a disclosure intervention for HIV+ mothers: the TRACK program. J Consult Clin Psychol 79:203-14
Murphy, Debra A; Marelich, William D; Armistead, Lisa et al. (2010) Anxiety/stress among mothers living with HIV: effects on parenting skills and child outcomes. AIDS Care 22:1449-58