Family-to-Family: Psychoeducation to Improve Children's Outcomes in HIV+ Families

University Of California Los Angeles, Los Angeles CA

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): HIV has a negative intergenerational impact on families, particularly children with HIV+ parents (Rotheram-Borus et al., 1997). In order to improve the social, behavioral and mental health outcomes for children affected by HIV, we have designed the Family-to-Family (F2F) intervention that includes the critical, universal, program components identified by the NIMH Intervention Workgroup (in revision). All efficacious intervention programs: frame the problem by providing information and shaping beliefs; enhance skills; establish supportive relationships; and remove environmental barriers to behavior change (e.g, HIV testing, ARV). We aim to evaluate a generic intervention approach that is culturally-tailored to families affected by HIV in a specific country, Thailand. The intervention builds on previous efficacious HIV family interventions, adapted to be sustainable in a developing country context. The F2F intervention for HIV+ parents and their family caregivers will assist families to cope with HIV-related stressors (disclosure, stigma, transmission, & custody), build skills for improving their own and their children's adjustment, and establish supportive community relationships with other families affected by HIV. Families in Thailand need such an intervention: 1 in 4 elderly adults in Thailand will raise an AIDS orphan, even with a relatively low national seroprevalence rate (1.2%). The study will proceed in 2 phases. In Phase 1, we will pilot and finalize the intervention, assessments, and procedures with 40 families, 10 of whom are "positive models." In Phase 2, families with HIV+ parents (400 HIV+ parents, 600 family caregivers) from 4 district hospitals in Chang Rai & Nakhon Ratchasima Provinces will be recruited to an intervention to benefit their 960 school-aged children aged 6-17 years. At their clinical care site, we will randomly assign families to either: 1) F2F, a psychoeducational intervention for HIV+ parents and family caregivers delivered in drop-in groups by healthcare providers (not including their children); or 2) a Standard Care intervention. The impact of the F2F intervention will be monitored over 24 months (baseline, 3, 6, 12, 18, & 24 months). The primary outcomes are school-age children's social, behavioral and mental health status. HIV+ parent's and family caregivers' health mental health, parenting skills, and family bonds are intermediate outcomes.