The Effect of Social Support on Mental and Behavioral Outcomes Among Adolescents With Parents With HIV/AIDS

Center for Community Health, University of California, Los Angeles, CA 90024, USA.
American Journal of Public Health (Impact Factor: 4.55). 11/2007; 97(10):1820-6. DOI: 10.2105/AJPH.2005.084871
Source: PubMed


We examined the associations between social support and mental and behavioral outcomes among adolescents whose parents were infected with or died of HIV/AIDS.
Families (parents who were HIV infected and their adolescent children) were randomly assigned to a coping skills intervention or a standard care group. After completing the intervention, the parents and adolescents were assessed for 2 years.
Adolescents who had more social support providers reported significantly lower levels of depression and fewer conduct problems; adolescents who had more negative influence from role models reported more behavior problems. Reductions in depression, multiple problem behaviors, and conduct problems were significantly associated with better social support.
Our findings underscore the complex relations between social support and mental and behavioral outcomes among adolescents affected by HIV/AIDS. Future prevention programs must focus on increasing social support to reduce negative outcomes among adolescents affected by HIV/AIDS as well as the need to reduce influence from negative role models.

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Available from: Sung-Jae Lee, Oct 10, 2015
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    • "other children living with healthy parents (Cluver et al. 2007; Rotheram-Borus et al. 2005). Some researchers found that depressive symptoms among children affected by HIV were associated with bereavement, family functioning , social support, poverty, perceived stigma, trauma, child labour, physical abuse, and access to school (Cluver and Gardner 2007; Hong et al. 2010; Lee et al. 2007; Nyamukapa et al. 2010). However, most of the existing research is either qualitative or quantitative studies using a cross-sectional design; few studies have examined linkages between psychosocial factors and depression among children affected by HIV based on prospective longitudinal data. "
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    ABSTRACT: The current study was designed to examine the trend of depression among children affected by HIV (n = 1,221) in rural China over a period of 3 years and to explore baseline psychosocial factors that can predict depressive symptoms at 1- and 2-year follow-ups. Baseline depression score, trusting relationship with caregivers, perceived public stigma against children affected by HIV, and future expectation at baseline positively predicted the 1-year follow-up depression, while children' self-report health status, self-esteem, and perceived social support negatively predicted depression at 1-year follow-up survey. Depression and self-report health status at baseline significantly predicted depression at the 2-year follow-up. The data in the current study suggested that depressive symptoms were chronic or recurring among some children affected by HIV/AIDS. The findings also underscore the importance of early identification, early intervention, and ongoing counseling for mental health problems among children affected by HIV/AIDS. Future psychological support programs need to target both mental health symptoms and resilient factors that will help these children to cope with adverse life events associated with HIV/AIDS.
    Journal of Child and Family Studies 10/2013; 23(7):1193-1200. DOI:10.1007/s10826-013-9780-8 · 1.42 Impact Factor
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    • "These studies spanned a broad range of intervention strategies , reflecting stakeholders' priorities and the timely HIV prevention and policy issues. Broadly speaking, these intervention approaches included coping skills (Heckman et al., 2006; Hyde et al., 2005; Lee et al., 2007; Rotheram-Borus et al., 2006; Weiss et al., 2011), treatment and cure (Allen et al., 2009; Munoz et al., 2010; Sacks et al., 2011), cultural activities (Airhihenbuwa et al., 2009; Mueller et al., 2011), community participation such as volunteerism and activism (Apinundecha et al., 2007; Ramirez-Valles, Fergus, Reisen, Poppen, & Zea, 2005), HIV/AIDS knowledge education and risk reduction counseling (Operario et al., 2010), voluntary counseling and testing (VCT) (Maman et al., 2009), peer-group support intervention (Kumakech et al., 2009), threelayered service (Kaleeba et al., 1997), child-directed group intervention (Clacherty & Donald, 2006), the introduction of home-based care (HBC) professionals (Waterman et al., 2007), and adult mentoring and support group (Horizons, 2006, 2007; Lavin et al., 2010; MEASURE, 2009a, 2009b, 2009c, 2009d, 2009e; Thurman et al., 2006). Since this section is lengthy, we distinguish quantitative studies from qualitative studies and report adult and children studies separately. "
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    ABSTRACT: Background: This review explores the current community-based psychosocial interventions among people living with HIV/AIDS (PLWHA) across the globe. Methods: Evaluation studies were retrieved and reviewed regarding study location, characteristics of participants, study design, intervention strategies, outcome indicators, and intervention findings. Results: The 28 studies spanned a broad range of intervention strategies, including coping skills, treatment and cure, cultural activities, community involvement, knowledge education, voluntary counseling and testing, peer-group support, three-layered service provision, child-directed group intervention, adult mentoring, and support group interventions. Regardless of study designs, all studies reported positive intervention effects, ranging from a reduction in HIV/AIDS stigma, loneliness, marginalization, distress, depression, anger, and anxiety to an increase in self-esteem, self-efficacy, coping skills, and quality of life. Conclusion: Although the existing studies have limitation with regard to program coverage, intensity, scope, and methodological challenges, they underscore the importance of developing community-based interventions to promote psychosocial well-being among PLWHA. Future studies need to employ more rigorous methodology and integrate contextual and institutional factors when implementing effective interventions.
    04/2013; 1(1):31-46. DOI:10.1080/21642850.2013.822798
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    • "However, limited data are available regarding social support and psychological health among children affected by AIDS. In a two-year intervention study among adolescents whose parents were infected with HIV/AIDS, it was found that reductions in depression, conduct problems, and problem behaviors were significantly associated with better social support (Lee et al., 2007). A qualitative study conducted in Southwest China reported that children living in HIV/AIDS affected families were suffering from a number of psychological problems including fear, anxiety, grief, and loss of selfesteem and confidence and the children relied heavily on caregivers and peers to gain psychological support (Xu et al., 2009). "
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    ABSTRACT: Previous research has revealed a negative impact of orphanhood and HIV-related stigma on the psychological well-being of children affected by HIV/AIDS. Little is known about psychological protective factors that can mitigate the effect of orphanhood and HIV-related stigma on psychological well-being. This research examines the relationships among several risk and protective factors for depression symptoms using structural equation modeling. Cross-sectional data were collected from 755 AIDS orphans and 466 children of HIV-positive parents aged 6-18 years in 2006-2007 in rural central China. Participants reported their experiences of traumatic events, perceived HIV-related stigma, perceived social support, future orientation, trusting relationships with current caregivers, and depression symptoms. We found that the experience of traumatic events and HIV-related stigma had a direct contributory effect on depression among children affected by HIV/AIDS. Trusting relationships together with future orientation and perceived social support mediated the effects of traumatic events and HIV-related stigma on depression. The final model demonstrated a dynamic interplay among future orientation, perceived social support and trusting relationships. Trusting relationships was the most proximate protective factor for depression. Perceived social support and future orientation were positively related to trusting relationships. We conclude that perceived social support, trusting relationships, and future orientation offer multiple levels of protection that can mitigate the effect of traumatic events and HIV-related stigma on depression. Trusting relationships with caregivers provides the most immediate source of psychological support. Future prevention interventions seeking to improve psychological well-being among children affected by HIV/AIDS should attend to these factors.
    Social Science [?] Medicine 02/2012; 74(9):1435-43. DOI:10.1016/j.socscimed.2012.01.007 · 2.89 Impact Factor
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