Predicting Depression in Mothers With and Without HIV: The Role of Social Support and Family Dynamics

Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, Room 2234GG, College Park, MD, 20742, USA, .
AIDS and Behavior (Impact Factor: 3.49). 02/2012; 16(8):2198-208. DOI: 10.1007/s10461-012-0149-6
Source: PubMed


Many women with HIV are primary caregivers for their children. Social factors, including family dynamics, play a major role in women's depression. We hypothesized an impact of HIV seropositivity on greater depression mediated through poorer family functioning and social support. Participants include 332 Mothers Living with HIV (MLH) and 200 Neighborhood Control Mothers (NCM) recruited in Los Angeles County. The NCM were matched by neighborhood. All had children ages 6 through 20. Analyses using structural equation modeling (SEM) indicated HIV seropositivity was positively correlated with depression and negatively correlated with positive social support and effective family functioning. In a predictive path model, the relationship between having HIV and depressed mood was mediated by social support and family functioning. Findings offer explanation for increased depression resulting from HIV and social and family dynamics, and suggest innovative interventions to abate psychosocial health problems and lower risk for depression among women with HIV.

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    ABSTRACT: AIM: This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care. BACKGROUND: Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual-level HIV prevention, HIV/AIDS family-focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention. DATA SOURCES: The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were 'nurse', or 'nursing', 'HIV/AIDS', 'family interventions', 'family support' and 'family education', and/or 'family subsystems'. DISCUSSION: The process of theorizing about 'family interventions' and 'HIV/AIDS-family interventions' is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective. CONCLUSION: Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS-FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family-focused approaches.
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    Full-text · Article · Apr 2014 · Journal of the International AIDS Society
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