Six-year intervention outcomes for adolescent children of parents with the human immunodeficiency virus

Abstract

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.