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Six-Year Intervention Outcomes for Adolescent Children of Parents With the Human Immunodeficiency Virus
Mary Jane Rotheram-Borus, PhD;
Martha Lee, PhD;
Ying-Ying Lin, MS;
Patricia Lester, MD
Arch Pediatr Adolesc Med. 2004;158:742-748.
Hypothesis Having a parent with the human immunodeficiency virus has a significant negative impact on an adolescent child's adjustment.
Objective To assess the adjustment of adolescent children to having a parent with the human immunodeficiency virus over 6 years, following the delivery of a coping skills intervention.
Design A randomized controlled trial with repeated evaluations that was analyzed with an intention-to-treat analysis. A skill-based intervention was delivered in 3 modules over 24 sessions, with the third module being delivered only if parents died.
Setting and Patients A representative sample of parents with the human immunodeficiency virus (n = 307) and their adolescent children (n = 423) was recruited from the Division of AIDS Services in New York City; 51.5% (n = 158) of the parents died.
Main Outcome Measures Employment and school enrollment, receiving public welfare support, early parenthood, mental health symptoms, and the quality of romantic relationships.
Results Over 6 years, significantly more adolescents in the intervention condition than the control condition were employed or in school (82.58% vs 68.94%), were less likely to receive public welfare payments (25.66% vs 36.65%), were less likely to have psychosomatic symptoms (mean, 0.24 vs 0.31), were more likely to report better problem-solving and conflict resolution skills in their romantic relationships (mean score, 4.38 vs 4.20), expected to have a partner with a good job (mean, 4.57 vs 4.19), and expected to be married when parenting (mean, 3.05 vs 2.40). With marginal significance, the percentage of parents in the intervention condition (34.6%) was less than in the control condition (44.1%).
Conclusion Physicians must consider the psychosocial consequences of illness-related challenges on children and provide interventions.
From the AIDS Institute and the Department of Psychiatry, University of California, Los Angeles.
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